161543 07/11/2008 CITY OF CARMEL, INDIANA VENDOR: 359594 Page 1 of 1
0 ONE CIVIC SQUARE ROCHESTER MIDLAND CORP
CARMEL, INDIANA 46032 PO BOX 31515 CHECK AMOUNT: $360.99
ROCHESTER NY 14603 -1515
CHECK NUMBER: 161543
CHECK DATE: 7/11/2008
D EPARTMENT AC COUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
905 4238900 589153 360.99 OTHER MAINT SUPPLIES
/z,
1 -800- 762 -4448 (1- 800 -RMC -4448)
RM C Ship -to: Invoice
ester Midland Corporation BROOKSHIRE GOLF CLUB
12120 BROOKSHIRE PARKWAY Page: 1 of 1
CARMEL IN 46033 Inv No: 5891
h�bchester Midland Corporation United States
PO 31515 Inv Date: 05- JUN -08
Rochester NY 14603 -1515 Purchase Order Number:
United States BRIAN
PO Date:
Order No: 477995
Bill -to: BROOKSHIRE GOLF CLUB Cust No: 35590
12120 BROOKSHIRE PARKWAY Location: IN- CARMEL01
CARMEL IN 46033
United States
Tax Reference:
0031201550 -020
Terms: 30 NET Due Date: 05- JUL -08 Salesrep: Trepcos, John
Ship Date: Ship Via: Contact:
Quantity
Item Prod Code Description UOM Ordered B/ Shipped Ta3 Unit PricE Extended Amt
1 12MO SVC HANDSFREE RESTROOM BILLING YEARLY EACH 1 1 N 360.99 360.99
JUN 2008 thru MAY 2009
Thank you for your business. Perhaps you have noti ed out NEW consolid itec invoice forma Although this change
looks a bit different, it still allows you to ideni ify tte billing opt on nd billing pe io Should a have any
questions, please call your Customer Service Repre entat ve at 1 -800 -R C-448. Please r me ber that all Sanor® drip
machines, fan units, aerosol dispensers and Hands IreeO auto flush and fa et units are ro ided by anc remain the
property of Rochester Midland.
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Subtotal Tax Total
z 360.99 0.001 360.99
Currency: USD
Please return this portion with your payment. Thank you.
Remit-to: Sh -to:
Rochester Midland Corporation BROOKSHIRE GOLF CLUB I n v o i c
PO BOX 31515 12120 BROOKSHIRE PARKWAY P 1 of 1
Rochester NY 14603 -1515 CARMEL IN 46033 Inv No: 589153
United States United States
Inv Date: 05- JUN -08
Purchase Order Number:
Bill -to: BRIAN
BROOKSHIRE GOLF CLUB PO Date:
12120 BROOKSHIRE PARKWAY Order No: 477995
CARMEL IN 46033
United States
Cust No: 35590
Location: IN- CARMEL01
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
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
Purchase Order No.
c oc (-N Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
�ls ic �15
1
Total rJ 9
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
Lciu
IN SUM OF
3C60_
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT /TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
C IO's 5T"I i S j 3(L�• 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
ftatur�l
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund