176295 08/19/2009 CITY OF CARMEL, INDIANA VENDOR: 361540 Page 1 of 1
of� ONE CIVIC SQUARE JAKE LAIRD GOLF OUTING CHECK AMOUNT: $400.00
CARMEL, INDIANA 46032 20491 COUNTRY PINE COURT
NOBLESVILLE IN 46062 CHECK NUMBER: 176295
CHECK DATE: 8119/2009
DEP ART M ENT ACCOUNT PO NUMB INVO NUMB AMOUNT DE SCRIPTION
X 052 5023990 400.00 OTHER EXPENSES
INVOICE
Date: August 13, 2009
Sold to: City of Carmel Police Department
3 Civic Square
Carmel, IN 46032
Jake Laird Golf Outing foursome $400.00
Tim Green
Sean Brady
Bob Locke
Marc Klein
Please make check payable to:
Jake Laird Golf Outing
20491 Country Pine Court
Noblesville, IN 46060
INDIANA RETAIL TAX EXEMPT PAGE
C i t y o II C sane CERTIFICATE N0.003120155 002 0 �1J' 11 Jl� PURCHASE ORDER NUMBER
Police Department FEDERAL EXCISE TAX EXEMPT
35- 60000972
3 CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/P
1
CARMEL, INDIANA 46032 2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
g olf out ing
VENDOR Jake Laird Golf Outing SHIP City of Carmel Police Department
20491 Country Pine Court TO 3 Civic Square
Noblesville, IN 46062 Cara &l, IN 46032
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Foursome 400.00
Tim Green
Sean Brady
Bob Locke
Marc Klein
"d I
Send Invoice To:
City of Carmel Po ce `a Wit>
ATTN: Teresa Anders
3 Civic Square
Carme.11 IN 46032
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT I PROJECT F PROJECT ACCOUNT AMOUNT
852 852 police gift fund PAYMENT
A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
SHIP REPAID, THIS A :MGN SUFFICIENT TO PAY FOR THE ABOVE ORDER,
C.O.D. SHIPMENTS CANNOT BE ACCEPTED.
PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY i
SHIPPING LABELS.
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE Chief Of Pol
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
2 CLERK TREASURER
DOCUMENT CONTROL NO. A.P.V COPY SIGN AND RETURN TO CLERKS OFFICE
VOUCHER NO. WARRANT NO,---
ALLOWED 20
IN THE SUM OF
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
Signature.-
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
P�i`�t> albed 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
Jake Laird Golf Outing Purchase Order No. 21074F
20491 Country Pine Court Terms
Noblesville, IN 46060 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
8/13/09 payment for foursome 400.00
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
Jake Laird Golf Outing IN SUM OF
20491 Country Pine Court
Noblesville, IN 46060
400.00
ON ACCOUNT OF APPROPRIATION FOR
police gift' -fund
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. 1 hereby certify that the attached invoice(s), or
21074F 852 400.00 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
August 13 20 09
Signature
Chief of POlice
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund