160519 06/10/2008 CITY OF CARMEL, INDIANA VENDOR: 00350268 Page 1 of 1
ONE CIVIC SQUARE PEERLESS MIDWEST, INC
CARMEL, INDIANA 46032 55860 RUSSELL INDUSTRIAL PARKWAY CHECK AMOUNT: $450.00
MISHAWAKA IN 46545
CHECK NUMBER: 160519
CHECK DATE: 6/10/2008
DEPA RTMENT ACCOUNT PO NUMBER INV NUMBER AMOUNT DESCRIPTION
905 4350100 23703 450.00 BUILDING REPAIRS MA
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Peerless Midwest Inc.
55860 Russell Industrial Parkway Mishawaka, Indiana 46545 219 254 -9050 Fax 219 -254 9650
Federal ID 35- 1284374
INVOICE NO. Vendor#
7036
Brookshire Golf Club 23703
SOLD TO 4 Accounts Payable TERMS- NET 30 DAYS. 1.5% SERVICE CHARGE (18% ANNUAL RATE) EACH
12120 Brookshire Pkwy MONTH THEREAFTER
Carmel IN 46033 Invoice Date Proj Mgr.
5/9/2008 TTH
S. O. No. Your Order No.
Brookshire Golf Club 22067 Bob Higgens
12120 Brookshire Pkwy Tax Exempt? Reason Tax Exempt
SHIP TO Carmel, IN 46033 Yes ❑x No
All Labor
Labor Cost Material Cost Tax
Test and Service (3) pumps on 4 -21 -08 450.00
TOTAL AMOUNT OF THIS INVOICE 450.00
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THANK YOU!
1 FILE: 21194
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 7995)
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
4 Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date p Number (or note attached invoice(s) or bill(s))
.2 ��liy� °l
Total S of
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
IN SUM OF
y G :N.Gc
J
ON ACCOUNT OF APPROPRIATION FOR
Board Members
Po# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
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c 2 37 03 50/ Sb °a 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
�o l0 2005
Lignat u e
G
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund