161461 07/11/2008 CITY OF CARMEL, INDIANA VENDOR: 361119 Page 1 of 1
ONE CIVIC SQUARE LUBRICATION SPECIALISTS OF NE FL CHECK AMOUNT: $109.90
CARMEL, INDIANA 46032 4941 MARINERS POINT DR
JACKSONVILLE FL 32225 CHECK NUMBER: 161461
CHECK DATE: 7/11/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
,-905 4238900 060806 109.90 OTHER MAINT SUPPLIES
I
www.prolong- usa.com Lubrication Specialists of NE Florida, LLC
N V O 1 C E 07 -07 -08 A10:45 IN
INVOICE 060806 DATE: 06 -25 -08
PO VERBAL JOHN JUDAY TERMS: NET 30
SHIP VIA: PALMER SALESPERSON: GARY PALMER 402 -0093
SOLD To: SHIP To:
BROOKSHIRE GOLF COURSE
CITY OF CARMEL SAME
CARMEL, IN 46032
ITEM QTY DESCRIPTION PRICE TOTAL
46000 10 PROLONG EP -2 GREASE- 14 oz. $9.90 $99.90
")0.
I
www.prolong- usa.com
SUS TOTAL $99.90
TAX
INV. PROCESSED THANK YOU SHIPPING $10.00
TOTAL $109.90
PLEASE REMIT TO:
LUBRICATION SPECIALISTS OF NE FLORIDA
4941 MARINERS POINT DRIVE
JACKSONVILLE FL32225
904 -716 -1407
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
L uc,fiL y� S('�.if:��1 Purchase Order No.
G 0 -cL Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
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 N WARRANT NO.
r'
ALLOWED 20
IN SUM OF
y
CO 9 L)
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
l ,'9 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 C.
!P
In It
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund