158237 04/14/2008 CITY OF CARMEL, INDIANA VENDOR: 359957 Page 1 of 1
ONE CIVIC SQUARE BLOCKOMS GOLF MANAGEMENT CO LLC
Q I� CARMEL, INDIANA 46032 7033 SEA OATS LANE CHECK AMOUNT: $98.80
INDIANAPOLIS IN 46250 CHECK NUMBER: 158237
CHECK DATE: 4/1412008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
905 4347500 98.80 GENERAL INSURANCE
7007 E PLEASANT VALLEY ROAD
CLEVELAND OH 44131 IiC1 438696
April 4, 2008 Page 1 of 2
Accounts receivable number:
00034 740397 00005365 01 AB 0.341 01 TR 0030 ROBCLVAI 10000
C008
PAUL BLOCKOMS
Any questions? Call your ADP BLOCKOMS GOLF MANAGEMENT
service representative, 12120 BROOKSHIRE PARKWAY
Your Client Service Team (866)505 -7273 CARMEL IN 46033 -3314
Current Request your FREE WHITE PAPER at wwW.adphire.com /resources
information Find out how"to minimize your hiring risks and maximize your financial returns with
ADP's new white paper, How You Can Automate Background Screening -and Tax Credits to
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1021
BLOCKOMS GOLF MANAGEMENT CO.
Q log
DATE 04' o 375
PAYT01 M IPD OF
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Please return the portion below with your payment in the enclosed return envelope. Include
your accounts receivable number on your check made out to ADP, Inc.
Send all service or general information correspondence to the address listed above or call
your Client Service Representative.
Return Stub Accounts receivable number: 00034 740397-,,
BLOCKOMS GOLF MANAGEMENT
�J Mail payment to: Product Company code: 10631
Invoice number: 438696
Invoice date: 04/04/2008
Lockbox number: 03
0
ADP, INC. Total due this invoice: $98.80 0
P.O BOX 78415 Payment due date: 04/11/2008 T
PHOENIX AZ 85062 -8415 Ln
Amount enclosed: I s 7
0030303407403970040408004386960000098801
Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by
whom,:,rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
w16 t�F Purchase Order No.
�Irt70 I Ye 6ot�F CAf f I Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
C4. 0 1.09 AID P 1A6 P
Total
I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accordance
with IC 5- 11- 10 -1.6.
20
Clerk- Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
��bC- 6 OAA(44 j eA 4
IN SUM OF
2bWo KA ire 606L r C JA,
ON ACCOUNT OF APPROPRIATION FOR
Board Members
Po# or INVOICE NO. F °ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
C/12� bill(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
..20
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund