176980 09/02/2009 CITY OF CARMEL, INDIANA VENDOR: 037500 Page 1 of 1
0 ONE CIVIC SQUARE WHITE'S ACE HARDWARE CHECK AMOUNT: $75.97
CARMEL, INDIANA 46032 731 S. RANGELINE ROAD
CARMEL IN 46032 CHECK NUMBER: 176980
CHECK DATE: 9/2/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239099 244 75.97 OTHER MISCELLANOUS
TYPE OF TRANSACTION DOCUMENT NUMBER TRANSACTION DATE ACCT NUMBER PAGE
35769629. 22 03/27/09 13:49:00 00 244 1
BILL TO: SHIP TO.'.
BROOKSHIRE GOLF CLUB BROOKSHIRE GOLF CLUB***
12120 BROOKSHIRE PKWY„ 12120 BROOKSHIRE PKWY.
ELI
m 1 N 46033
URCHASER: CASHIER: PO #e TERMS: SALESMAN:
QUANTITY ITEM NUMBER DESCRIPTION PRICE /UNIT AMOUNT
i 9098 PROPANE T 15.490 15. 49
tLD# TANK
HOUSE 15,48 TAXABLE
Jill' TAX
a, NON- TAXABLE
6
SUB -TOTAL
t
RECEIVED THE ABOVE IN GOOD CONDITION
J TOTAL
1 c 4
7 ,:3 1 'C- IFS 0=1 P4 C3 L- Y N EF- R n
a 211 1 1
ffTYPEOF NSACT ION DOCUMENT NUMBER TRANSACTION DATE ACCT NUMBER PAGE
3576425`3 22 08/17/09 10:38:06 000244 1
3
BILL TO: SHIP TO:
�;w
BROOKSHIRE GOLF CLUB BROOKSHIRE GOLF CLUB***
42120 BROOKSHIRE PKWY. 12120 BROOKSHIRE PKWY.
CARREL IN 46033 CARREL IN 46033
URCHASER-. CASHIER: PO #e TERMS: SALESMAN:
EN MILLER MIMI
QUANTITY ITEM 'NUMBER DESCRIPTION C r PRICE /UNIT AMOUNT
c s+ M 4.990. 44.99
1 9098 PROPANE T 15.490 15.49
2Z,# TANK
H USE l'
t. N
48
TAXABLE
.00
p TAX
60.46
i NON TAXABLE
fY 60.46
SUB-TOTAL
RECEIVED THE ABOVE IN GOOD CONDITION 60.48
TOTAL
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 207 (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
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
S e �i
a 6 4 LA__
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
791 oS P�
ON ACCOUNT OF APPROPRIATION FOR
,�20 -7�
Board Members
PO# or D PT. INVOICE NO. ACCT #TITLE AMOUNT I hereby certify that the attached invoice(s), or
P26 ,7S �7p_ bill(s) is (are) true and correct and that the
.5' y materials or services itemized thereon for
which charge is made were ordered and
received except
20 D
Signatur
itle
Cost distribution ledger classification if
claim paid motor vehicle highway fund