178173 10/14/2009 CITY OF CARMEL, INDIANA VENDOR: 359590 Page 1 of 1
ONE CIVIC SQUARE H2 GOLF COMPANY
•I� I' CHECK AMOUNT: $288.00
CARMEL, INDIANA 46032 317 GRADLE DR
Li oM CARMEL IN 46032 CHECK NUMBER: 178173
CHECK DATE: 10/14/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4356007 202 288.00 GOLF HARDGOODS
H2 Golf Company I nvoice
317 Gradle Drive
Date Invoice
Carmel, IN 46032
9/29/2009 202
Bill To Ship To
Brooshire Golf Course Brooshire Golf
Brian Ballard Brian Ballard
12120 Brookshire Pkwy 12120 Brookshire Pkwy
Carmel_ In 46033 Carmel, IN 46033
P.O. Number Terms Rep Ship Via F.O.B. Project
Due on receipt PH 9/29/2009
Quantity Item Code Description Price Each Amount
1 SKYCD Sky Caddie SG -5 w/ accessories 288.00 288.00
Tota $288.00
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
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
G a T Purchase Order No.
Terms
y�o�a
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
a 9 r
Total 2A UD
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
Board Members
PO# or DEPT INVOICE NO. ACCT #!TITLE AMOUNT I hereby certify that the attached invoice(s), or
aC�7 p Oro ti 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 67
Sigs �atur
r1�1 /L
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund