170001 03/18/2009 CITY OF CARMEL, INDIANA VENDOR: 361119 Page 1 of 1
ONE CIVIC SQUARE LUBRICATION SPECIALISTS OF NE FL
i CHECK AMOUNT: $53.94
o CARMEL, INDIANA 46032 4941 MARINERS POINT DR
X JACKSONVILLE FL 32225 CHECK NUMBER: 170001
CHECK DATE: 3/18/2009
DEPAR `MENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4350000 100808 53.94 EQUIPMENT REPAIRS M
www.pr.�olong-usa.com Lubrication Specialists of NE Florida, LLC
I N V O I C E
INVOICE 100808 DATE 10 -31 -08
PO VERBAL TERMS: NET 30
SHIP VIA: PALMER SALESPERSON: GARY PALMER 317 -402 -0093
SOLD TO: SHIP TO:
BROOKSHIRE GOLF COURSE SAME
CITY OF CARMEL
CARMEL, IN
ITEM QTY DESCRIPTION PRICE TOTAL
60017 6 PROLONG SUPER PROTECTANT- 17 OZ. $8.99 $53.94
www.prolong- usa.com
SUB TOTAL $53.94
TAX
INV. PROCESSED THANK YOU SHIPPING N/C
TOTAL $53.94
PLEASE REMIT TO:
LUBRICATION SPECIALISTS OF NE FLORIDA
4941 MARINERS POINT DRIVE RECEI�TD
JACKSONVILLE FL32225
904- 716 -1407 FEB 2 6 2009
BY.
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
1
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.
I,, Payee
L U b PI 4'4a s o,-� rchase Order No.
S A,'A_Yf _09 JF-, Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
S
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.
p r ALLOWED 20
IN SUM OF
9V
ON ACCOUNT OF APPROPRIATION FOR
&-N&ea
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
%?D'7 66kok cZ c�Z� 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
S 2nature
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund