178213 10/14/2009 CITY OF CARMEL, INDIANA VENDOR: 359984 Page 1 of 1
.I
0 ONE CIVIC SQUARE INDIANA GOLF CAR CHECK AMOUNT: $35.10
CARMEL, INDIANA 46032 1770 B EAST 266TH STREET
ARCADIA IN 46030 CHECK NUMBER: 178213
CHECK DATE: 10/14/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4351000 934 35.10 AUTO REPAIR MAINTEN
r
E Indiana Golf Car, Inc. Invoice
1770 B E 266th
Date Invoice
Arcadia, IN 46030
913012009 934
Bill To Ship To
CARMEL POLICE DEFT CARMEL POLICE DEFT
ATT:TERESA ANDERSON ATT:TERESA ANDERSON
CARMEL, IN 46032 CARMEL, IN 46032
P.O. Number Terms Rep Ship Via F.O.B. Project
Net 30 9/30/2009
Quantity Item Code Description Price Each Amount
1 1016879 HEADLIGHT BEZEL -RIGHT 93 9.20 9.20T
1 CCX8506 CIRCUIT BREAKER, 15A/120V 10.90 10.90T
1 REPAIR LABOR REPAIR LABOR 15.00 15.00
State Sales Tax 7.00% 1
Total 51
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
Indiana Golf Car, Inc. Purchase Order No.
17q0 B E 266th Street Terms
ARcadia, IN 4603V' Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
9/3 0/09 4 re airs to g6lf cart 35.10
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
'AER NO. WARRANT NO.
ALLOWED 20
f l ndiana Golf Car, Inc.
IN SUM OF
1770 B E 266th Street
Arcadia, IN 46030
35.10
ON ACCOUNT OF APPROPRIATION FOR
police generallfundd
Board Members
PO# or INVOICE NO. ACCT #!TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
1110 934 510 35.10 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
October 6 20 09
Signature
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund