HomeMy WebLinkAbout170973 04/16/2009 CITY OF CARMEL, INDIANA VENDOR: 361429 Page 1 of 1
ONE CIVIC SQUARE M D A CHECK AMOUNT: $351.64
CARMEL, INDIANA 46032 PO Box 794
MONUMENT CO 80132 CHECK NUMBER: 170973
CHECK DATE: 4/16/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4356006 25763 351.64 GOLF SOFTGOODS
Pi
I
(MDA) MAXX SUNGLASSES INVOICE
MAXX SUNGLASSES
PO BOX 794 DATE INVOICE
MONUMENT CO 80132
3/26/2009 25763
BILL TO SHIP TO
Brookshire Golf Club IN Brookshire Golf Club IN
MELISSA MONTGOMERY MELISSA MONTGOMERY
12120 Brookshire Parkway 12120 Brookshire Parkway
Carmel, IN 46033 Carmel, IN 46033
TERMS DUE DATE REP SHIP VIA
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QUANTITY DESCRIPTION EA AMOUNT
2 MAXX GOLF L -STAND 0.00 0.00
14 MAXX 2 (6 BK, 4 CH, 2 RED, 2 BLU) 7.00 98.00
6 MAXX 3 (2 BK, 2 BLU, 2 RED) 7.00 42.00
8 MAXX 4 (2 WH, 2 CIN, 2 PK, 2 PUR) 7.00 56.00
14 MAXX CINCO (4 BK, 4 WH, 3 RED, 3 BLU) 7.00 98.00
4 MAXX REVOLUTION (2 BK, 2 WH) 7.00 28.00
2 MAXX DESIGNER (1 BK, 1 TOR) 7.00 14.00
1 MAXX DESIGNER WHITE FOR MELISSA 0.00 0.00
1 MAXX HD LARGE WRAPAROUNDS SAMPLE 0.00 0.00
SHIPPING HANDLING (2 BOXES) 15.64 15.64
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HELP US KEEF PRICES LOW! IF THESE BOXES ARE BLANK WE DON'T HAVE YOUR FAX OR ff MAIL ADDRESS DIN FILE!
Customer E mail Customer Fax
I i I
PLEASE MAKE CHECKS PAYABLE TO "MDA"
WE ACCEPT MASTER CARD, VISA AND DISCOVER THIS INVOICE $351.64
877.550.8116 PHONE
719.622.1153 FAX TOTAL DUE THIS ACCOUNT $351.64
PrescribeXby Std:. 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.
'1 22 04 y� Payee
i Anq Kx q 112 .5 e s Purchase Order No.
4 13 7 9 1 Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(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.
ALLOWED 20
IN SUM OF
9
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or DEPT. INVOICE NO. ACCT #/TITLE AMOUNT I hereby certify that the attached invoice(s), or
o 20 3 v 35/. 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
:a �4ignature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund