178495 10/20/2009 a CITY OF CARMEL, INDIANA VENDOR: 00350929 Page 1 of 'I
V A T P ONE CIVIC SQUARE INDIANA DEPT OF REVENUE PO CHECK AMOUNT: $317.02
CARMEL INDIANA 46032 eox 7226
INDIANAPOLIS IN 46207 CHECK NUMBER: 178495
CHECK DATE: 1012012009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
101 5023990 F B GOLF 9 317.02 GOLF -F B 09/09
i
FAB 103 0808
V Audwri,d r
A sis��mr� Total Sales of Food Beverages (Do Not I nclude Tax)_....... A.
declare under penalties fperjugthat this is a cor ecta d complete recur
g@��1� Total Exempt Food Beverage Sales B.
B.
Date _�tC Phonep i 1
Net Taxable Sales (Subtract Line B from Line A) C. Q Z
BROOKSHIRE GOLF CLUB Tax Due(1 %of Line C) D. I C' 1 j
CARMEL UTILITIES couectionAUowa nce (.73% of Line D)
Taxpayer ID Number For Tax Period Do Not Use this Line ifthe Payment is Late.. E-
0003120155 004 0 SEP 2009 5
Nel'I'ax Due (Subtract Line E from Line D) F.
Penalty is Greater of SS or 10 %of Line F (Plus Interest)'
County /Town Due on or Before Use this line onl_ vifretumis filed late G.
Carmel OCT 30 2009 *The 2009 Annual Interest Rate is 7%
Adjustments (An explanation must be attached) H.
Q I�tl�ltltlntll�ll�l���ll�llnll�lnl Total Amount Due (Total Lines F and G plus or minus H) I I
INDIANA DEPARTMENT OF REVENUE
P.O. BOX 7229
INDIANAPOLIS,IN 46207 -7229
04000 0 11355495101025093020091030200904
f
I
FAB -103 0808
X O d Total Sales of Food Beverages (Do Not Include Tax) A.
s s ue. r
declare un er penalles ofperjury that this is a ue, correct. d co ete
�j Total Exempt Food &Beverage Sales B.
Date Phone t/ l
Net Taxable Sales (Subtract Line B from Line A) C. y o
BROOKSHIRE GOLF CLUB Tax Due (1% ofLine C) D. l �O
CARMEL UTILITIES Collection Allowance (.73% ofLine D)
Taxpayer ID Number For Tax Period Do Not Use this Line ifthe Payment is Late E. p
0003120155 004 0 SEP 2009
Net Tax Due (Subtract Line E from Line D) F.
County /Town Due ❑n or Before PenaltyisGreaierof $5or10 %ofLineF (Plus Interest)*
Y
Hampton OCT 30 2Be line only ifretumisfiledlate G.
'The 2009 Annual interest Rate is 7%
Adjustments (An explanation must be attached) H. l
I
lul�l�l�ln�lltll�n�rll�lln�l�lnl Total Amount Due (Total Lines F and G plus or minus hl) I.$ I
INDIANA DEPARTMENT OF REVENUE
P.O. BOX 7229
INDIANAPOLIS,IN 46207 -7229
04000011355495001025093020091030200909
x
CITY OF CARMEL
Brookshire Golf Course
Calculation of Sales and Food Beverage Taxes Owed
September 30, 2009
Total Non Taxable Taxable
Sales Sales Sales
Green Fees 58,988.82 58,988.82 0.00
Membership Fees 0.00 0.00 0.00
Cart Fees 13,739.22 13,739.22
Member Cart Fees 0.00 0.00
Gift Cards Sold 2,402.00 2,402.00 0.00
Pro Shop Non Taxable 0.00 0.00 0.00
Pro Shop Taxable 7,730.77 7,730.77
Food and Beverage Non Taxable 746.60 746.60 0.00
Food and Beverage Taxable 15,967.72 15,967.72
Total 99,575.13 62,137.42 37,437.71
Total Non Taxable Taxable Tax
Sales Sales Sales Payable
Sales Tax 99,575.13 62,137.42 37,437.71 2,620.64
Interest 0.00
Penalty 0.00
Collection Allowance (19.13)
2,601.51
Carmel Hamilton
Total Non Taxable Taxable FAB Tax FAB Tax
Sales Sales Sales Payable Payable
FAB Tax 15,967.72 0.00 15,967.72 159.68 159.68
Interest 0.00 0.00
Penalty 0.00 0.00
'Collection Allowance (1.17) (1.17)
158.51 158.51
Total Period Sales Taxes Owed 2,601.51
Total Period FAB Taxes Owed 317.02
2,918.53
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
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoices) 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 NO. WARRANT NO.
ALLOWED 20
IN SUM OF
L�A7
ON ACCOUNT OF APPROPRIATION FOR
Board Members
Po# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
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
a
Sig u a
Cost distribution ledger classification if Title IV
claim paid motor vehicle highway fund