176498 08/19/2009 CITY OF CARMEL, INDIANA VENDOR: 037500 Page 1 of 1
ONE CIVIC SQUARE WHITE'S ACE HARDWARE CHECK AMOUNT: $159.00
CARMEL, INDIANA 46032 731 S. RANGELINE ROAD
«o CARMEL IN 46032 CHECK NUMBER: 176498
CHECK DATE: 8/19/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 244 77.45 FOOD BEVERAGES
1207 4239099 244 4.99 OTHER MISCELLANOUS
1207 4350100 244 76.56 BUILDING REPAIRS MA
TYPE OF TRANSACTION DOCUMENT NUMBER TRANSACTION DATE ACCT NUMBER PAGE
4OUSE 35781954 28 08/13/09 09:19 :28 000244 1
BILL T0: SHIP TO:
BROOKSHIRE GOLF CLUB BROOKSHIRE GOLF CLUB***
12120 BROOKSHIRE PKWY. 12120 BROOKSHIRE PKWY.
CARMEL IN 48033 CARMEL IN 46033
'URCHASER: CASHIER„ PO #s TERMS: SALESMAN:
%EN MILLER PORTIA
QUANTITY ITEM NUMBER DESCRIPTION PRICE /UNIT AMOUNT
r
3 9098 PROPANE T 15.490 48.47
TANK
CPO
HOUSE. 46.47 TAXABLE .00
TAX .Ott
NON- TAXABLE 46.47
SUB -TOTAL 48.47
X
RECEIVED THE ABOVE IN GOOD CONDITION
TOTAL 46.47
w" I _r r=: V S; C4 F= C11 R n w f:41 R
7 Z 1 E3 FR 9=1 M C3 EZI I PJ E-Z R 13
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TYP "5 NSACTION D% ER A W5 A I T R 7zr-
PAG
BILL TO: SHIP TO:
BROOKSHIRE GOLF CLUB*** BROOKSHIRE GOLF CLUB***
12120 BROOKSHIRE PKWY. 121.20 BROOKSHIRE PKWY.
CARMEL :IN 46033 CARMEL IN 46033
PURCHASER CASHIER- pn TERM!;- RAI r
KEN MILLER Mimi
QUANTITY] ITEM NUMWf60 SCREW EYE ZN PRICE/UNIT4 AMOUNT
W .42
SCREW EYE 114x,:,
51600 SCREW EYE 1/4X3-3/4 ZN T :420 :42
51559 SCREW EYE 1-1/2" ZN PK5 T 1.030 1.03
51600 SCREW EYE 1/4X3-3/4 ZN T .420 .42
51510 CEILING HOOK 2-1/2 ZN PK3 T 1.330 1.33
51510 CEILING HOOK 2-1/2 ZN PK3 t 1.330 1.33
2 5307947 DOUBLE PULLEY FIXED I" T 2.970 5.94
2 5268289 SINGLE PULLEY FIXED I" T 1.690 3.38
1 5307655 ROPE CLEAT 4-1/2" ZN T 3.490 3.49
1 79101 CHAIN QUICK LINK 1/8"GALV T 1.990 1.99
1 79101 CHAIN QUICK LINK 1/8"GALV T 1.990 1.99
TAXABLE
CONTINUED ON NEXT PAGE XXXXX
TAX
XXXXXXXX
NON-TAXABLE
XXXXXXXX
SUB-TOTAL
CONTINUED NEXT PAGE xxxxxxxx
X XXXXXXXX
RECEIVED THE ABOVE IN GOOD CONDITION
TOTAL
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BROOKSHIRE GOLF CLUB BROOKSHIRE GOLF CLUB*
12120 BROOKSHIRE PKWY. 12120 BROOKSHIRE PKWY.
CARMEL IN 46033 CARMEL IN 46033
PO TERMS: SALESMAN:
KEN MILLER MIMI
QUANTITIj ITEM NUM 9 c f2 1 NYL BRD FRW IP 89q6" 501 PRICE /tN AMOUNt. 94
0 ivi
HOUSE 34.11 .0
TAXABLE
TAX 34.11
NON TAXABLE 34. 11
SUB -TOTAL
X• Y,)L, 34. 11
E E OVE IN OD CONDITION
TOTAL
Z _rE_ E3 64 C P4I R n WrA F;Z EF-
7
TYPE OF TRANSACTION a6guMENT NUMBER TRANSACTION DATE ACCT NUMBER PAGE
HOUSE \'35"758133 20 08406/09 08:45:28 000244
BILL TO: SHIP TO:
BROOKSHIRE GOLFCLUB*** BROOKSHIRE GOLF CLUB***
12120 BROOKSHIREPKWY. 12120 BROOKSHIRE PKWY.
Y.,
CARMEL IN 46033 CARMEL IN 46033
PURCHASER:
CASHIER: PO TERMS: SALESMAN.
KEN MILLER TRACI
QUANTITY ITEM NUMBER DESCRIPTION PRICE/UNIT AMOUN=T
1 1 5012 1 5 PADLOCK 1-1/2 KEYED 3918 T 8.490 8.49
1 50125 PADLOCK: 1-1/2 KEYED 3918 T 8.490 .8.49
1 50125 PADLOCK 1-1/2 KEYED 391.8 T 8.490 18.49
1 50125 PADLOCK 1-1/2 KEYED 391.8 T 8.490 8.49
50125 PADLOCK KEYED `3918 T 8.490 8.49
HOUSE 42.45 TAXABLE .00
TAX .00
NON-TAXABLE 42.45
SUB-TOTAL
42.43
TECEIVt/HE ABOVE IN GOOD CONDITION
TOTAL 42.45
_7Z3 I !E3 GRAB°+•8OE:L_ I MF—=' Rn
f
TYPE OF TRANSACTION DOCUMENT NUMBER TRANSACTION DATE ACCT NUMBER PAGE
HOUSE 35757246 20 08/04/09`,312 :00 :32 000244 1
e x RECEIPT REPRINT xxxx !a+
BILL TO: SHIP TO-
BROOKSHIRE GOLP',CLUB*** BROOKS ME GOLF CLUB***
121 BROOKSHIgE''PKWY. 12120 BROOKSHIRE PKWY.
CARMEL IN 46032j� CARMEL IN 46033
PURCHASER: CASHIER: PO TERMS: SALESMAN:
KEN MILLER MIMI"
QUANTITY ITEM NUMBER= DESCRIPTION PRICE /UNIT AMOUNT
1202415 CLOROX BLEACH ,GERM -182^0 2,- T 4e 990 4. 99'
t
ti
HOUSE 4.99 TAXABLE r 00
TAX
NON- TAXABLE 4.99
4.99
SUB TOTAL.
r
X
RECEIVED THE ABO IN GOOD CONDITION
TOTAL
W" I _F RE T E3 n- C E- F) R n W r-21 RE-
I E3 R'd::4P4C-31= I P4[= Rn
C: If R M E L_ I t%.0 C-1 OD 13;E:
22 Z3 1 1
TYPE OF TRANSACTION DOCUMENT NUMBER TRANSACTION DATE ACCT NUMBER PAGE
I-LOUSE 35751.319 20 07/24/09 12:32:36 000244 1
BILL TO: SHIP TO:
BROOKSHIRE GOLF CLUB***
BROOKSHIRE GOLF CLUB-***
12120 BROOKSHIRE PKWY. 12120 BROOKSHIRE PKWY.
CARMEL IN 46033 CARMEL IN 46033
PURCHASER: CASHIER: PO TERMS- SALESMAN:
KEN MILLER TRACI
QUANTITY ITEM NUMBER DESCRIPTION PRICE/UNIT AMOUNT
1 9098 PROPANE T 15.490 15.49
20# TANK
1 9098 PROPANE T 15.490 15.49
20# TANK,
HOUSE 30.98 TAXABLE .001
TAX .00
)6Pn 4- NON-TAXABLE 30.98
SUB-TOTAL 30.98
RECEIVE HE ABOVE IN GOOD CONDITION TOTAL 30.98
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
L�C/f�f� Gf' Purchase Order No.
A-)1 AQ Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
35 s�
7 110q 3f
7 sr 9
0�? 3s761�Y�
Total
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.
J ALLOWED 20
IN SUM OF
ON ACCOUNT OF APPROPRIATION FOR
7 6:14
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
3 9 36,9f bill(s) is (are) true and correct and that the
o -ov i/ materials or services itemized thereon for
.3 S a/ -Ue-1 44 which charge is made were ordered and
S 7
-5'7 o?V( �Q 5 received except
3S71a 9 0 39 0 -qv
20
A in 1,
ignature
title
Cost distribution ledger classification if
claim paid motor vehicle highway fund