173875 06/24/2009 CITY OF CARMEL, INDIANA VENDOR: 359984 Page 1 of 1
ONE CIVIC SQUARE INDIANA GOLF CAR
i CARMEL, INDIANA 46032
1770 B EAST 266TH STREET CHECK AMOUNT: $373.88
y'k }on ARCADIA IN 46030 CHECK NUMBER: 173875
CHECK DATE: 6/24/2009
DEPARTMENT ACCOUNT PO NUMB INVOI N AMOUNT DESCRIPTION
1207 4350000 264 373.88 EQUIPMENT REPAIRS M
Indiana Golf Car, Inc. Invoice
1770 B E 266th
Date Invoice
Arcadia, IN 46030
6/12/2009 264
'r Bill To Ship To
BROOKSHIRE G.C. BROOKSHIRE G.C.
12120 BROOKSHIRE PKWY. 12120 BROOKSHIRE PKWY.
CARMEL, IN 46033 CARMEL, IN 46033
P.O. Number Terms Rep Ship Via F.O.B. Project
Net 30 6/12/2009
Quantity Item Code Description Price Each Amount
1 101833701 STARTER- GENERATOR (CW) 310.20 310.20
1 1014289 PULLEY, STARTER- GENERATOR 32.90 32.90
Total $343.10
A
Indiana Golf Car, Inc. Invoice
1770 B E 266th
Date Invoice
Arcadia, IN 46030
6/12/2009 264
si Bill To Ship To
BROOKSHIRE G.C. BROOKSHIRE G.C.
12120 BROOKSHIRE PKWY. 12120 BROOKSHIRE PKWY.
CARMEL, IN 46033 CARMEL, IN 46033
P.O. Number Terms Rep Ship Via F.O.B. Project
Net 30 6/12/2009
Quantity Item Code Description Price Each Amount
1 101833701 STARTER- GENERATOR (CW) 0.00 0.00
1 1014289 PULLEY, STARTER GENERATOR 0.00 0,00
1 102711201 ASM, VOLTAGE REGULATOR 26.50 26.50
1 102289701 UPPER CLEVIS ASSEMBLY -LH 4.28 4.28
RETURNED STARTER AND PULLEY
Total $30.78
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
i "g4fA �i-�C' Purchase Order No.
1 7 2 .0 Terms
�QCR2 ��1 <o63d Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
.30 -W
3y3 16
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
IN SUM OF
ON ACCOUNT OF APPROPRIATION FOR
P-02 r0614 cum
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
3D.?,? bill(s) is (are) true and correct and that the
0��a 5 o cn� SIO materials or services itemized thereon for
which charge is made were ordered and
received except
20
Sign
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund