206342 02/14/2012 CITY OF CARMEL, INDIANA VENDOR: 361429 Page 1 of 1
ONE CIVIC SQUARE M D A
CARMEL, INDIANA 46032 PO BOX 3110 CHECK AMOUNT: $430.62
MONUMENT CO 80132
o CHECK NUMBER: 206342
CHECK DATE: 2/14/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4356006 77404 430.62 GOLF SOFTGOODS
(MDA) MAXX SUNGLASSES Invoice
MAXX SUNGLASSES Date Invoice
PO BOX 3110
MONUMENT, CO 80132 1/26/2012 77404
Bill To: Ship To:
Brookshire Golf Club IN Brookshire Golf Club IN
BRIAN BRIAN
12120 Brookshire Parkway 12120 Brookshire Parkway
Carmel, IN 46033 Carmel, IN 46033
Terms Due Rep Ship Date Via
Net 30 i 2/25%2012 DR 1/26/2012 UPS
Qty Description Each Amount
4 Cinco Black 8.50 34.00
4 Maxx 2 Black 8.50 34.00
3 Sport Black 8.50 25.50
3 Sport White 8.50 25.50
2 Storm Black 8.50 17.00
2 Storm White 8.50 17.00
2 Storm Tortoise 8.50 17.00
3 Sniper Black with red 8.50 25.50
3 Sniper Black with white 8.50 25.50
4 Stealth Black 8.50 34.00
4 Raven Black with White 8.50 34.00
2 Raven Silver with Black 8.50 17.00
4 GT Black 8.50 34.00
4 GT Copper 8.50 34.00
2 Maxx Revolution Blue 8.50 17.00
2 Maxx Revolution Red 8.50 17.00
1 STAND 24 (Graphic) 0.00 0.00
1 SUCCESS CARDS /PACK OF TEN 0.00 0.00
UPS SHIPPING 22.62 22.62
*New Catalog
Shipped On: 01/26/2012 Tracking 1ZF21Y460350619057, 0.00 0.00
1ZF21Y460349246864
Help us keep prices low! If these boxes are blank, please fill in and fax this page back to us. We will update your information!
e -mail: BBALLARD@CARMEL. IN. GOV Fax: 317 -846 -9980
Total This Invoice $430.62
PLEASE MAKE CHECKS PAYABLE TO "MDA"
WE ACCEPT MASTER CARD, VISA AND DISCOVER Payments/ Credits Applied to Invoice $0.00
877.550.8116 PHONE Balance Due $430.62
719.622.1153 FAX
Total Due This Account $430.62
Please inspect product carefully. All returns are to be made within 10 days of receipt and accompanied by a return authorization number (RA
Any problems should be gone over with your sales representative. If you feel you need additional assistance, please ask for Kelly ext 556
Drescribed by State Board of Accounts city Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
4n invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by
Nhom, 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 invoice(s) or bill(s))
01/26/12 77404 Sunglasses $430.62
1 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
M DA
IN SUM OF
P.O. Box 3110
Monument, CO 80132
$430.62
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1207 77404 43- 560.06 $430.62 1 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
Wednesday, February 08, 2012
Director, Brookshlr Golf Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund