175118 07/22/2009 CITY OF CARMEL, INDIANA VENDOR: 00350958 Page 1 of 1
ONE CIVIC SQUARE SAMS CLUB DIRECT
s'. a CARMEL, INDIANA 46032 P 0 BOX 530930 CHECK AMOUNT: $158.71
a o ATLANTA GA 30353 -0930 CHECK NUMBER: 175118
CHECK DATE: 7/22/2009
DEPA AC P O NUMBER INVOICE NUMBER A MOUNT DESCRIPTION
601 5023990 005170 158.71 OTHER EXPENSES
PAYMENT STUB
COMMERCIAL p 1 of 2
SAM'S CLUB DIRECT CREDIT
Page: 1 of 2 Account: 0402 7024011 9
Account: 0402 70240115 9 Statem ent Date: 06120109 CITY OF CARMEL
ATTN: ACCOUNTS PAYABLE
TWO CMC SQUARE
CARMEL, IN 46032.25
PLEASE INDICATE ADDRESS CHANGES
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3610 PAYMENT ADDRESS
CITY OF CARMEL SAM'S CLUB DIRECT
ATTN ACCOUNTS PAYABLE p gOX 530930
4
op CIVIiNS6032 -2584
N
CARMEL, ATLANTA, GA 30353 -09
k
DUE "DA►tE �II98109
payments Received
C (184.01) PAYMENT RECE
U
530
Details Enclosed) amount
Current Month's Invoices Date Invoice
Reference Invoices Paid
Amount Due Dat e Club please indicate by 98.96
Date Invoice 05/26109 001579
37.62
98.96 07108109 8`168 8168 052509 05r2 7109 007737 aw 158.71
05!26109 001579 06!04/09 005170 L�
37.62 07/08109
05127109 007737 158.71 07108/09 6316 06042009
06104109 005170
O
SAM'S CLUB DIRECT CREDIT
Account: 0402 70240115 9 Statement Date: 06120109 Page: 2 of 2
SAM'S CLUB DIRECT
P.O. BOX 530930
ATLANTA, GA 30353 -0930
Date of Sate: 05126/09
CITY OF CARMEL Invoice: 001579
Account: 0402 70240115 9 P 052509
ClublName: 8168 Buyer: GARY CARTER
S.K.U. DESCRIPTION QUANTITY UNIT PRICE EXT. PRICE
FOLGERS REG PCH GRD 4.00 EA 19.77 79.08
005045458 1.00 EA 19.88 19.88
001001818 5 GAL COOLER
Subtotal: 98.96 Tax: 0.00
Balance Due: 98.96
SAM'S CLUB DIRECT
c P.O. BOX 530930
LANTA, GA 30353 -0930
Date of Sate: 05/27109
CITY OF CARMEL Invoice: 007737
Account: 0402 70240115 9 P.O.:
ClublName: 8168 I Bar: NANCYHECK
QUANTITY UNIT PRICE EXT. PRICE
S.K U. DESCRIPTION 5.7s
002378701
v 1.00 EA 5.76
DRY ROASTED PEANUTS
S2 CAN COOLER 1'00 EA 2918 2918
010021527
Subtotal: 35.54 Tax: 2.08
Balance Due: 37.62
SAM'S CLUB DIRECT
P.O. BOX 530930
ATLANTA, GA 303
Date of Sale: 06104109
C F CARMEL Invoice: 005170
Account 0402 70240115 9 P.O.: 06042009
ClublName: 6316 Buyer: JERRY SMITH
DESCRIPTION QUANTITY UNIT PRICE_ EXT. PRICE
S.K.U. 1.00 EA 8.53 8.53
003680819 WINDEX 1,00 EA 7.58 7.58
004971574 CLOROX BLCH 31182 OZ t.00 EA 6.78 6.78
005103429 MR. CLEAN SUM CIT 3.00 EA 4.46 13.38
005213963 ORKS TBC 1 EA 16.93 16.93
005278116 48 AA TTERIES 100 EA 5.6B 5.68
005296226 TTLES 12,53
PACK 1.00 EA 12.53
005414489 1.00 EA 9.88 9.88
005770834 P FFS PLUS LOTION 1.00 EA 10.46 10.46
006027607 FORMULA 409 136+2X32 32.52
WISK 2X HE 110LD 172 2.00 EA 16.26 H
006106857 2 EA 17.22 34.44
017827020 BOUNTY 12 MR WHITE
Balance Due: 158.71
Subtotal: 158.71 Tax: 0.00
001 07 *PAof
COLR654A 3610
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CLUB MANAGER PATTI.MiTCHELL Y
31.7 71`'- 71`35
Fax and Pal l 7153
INDIANREJLIS, IN
06/04109 1 A �52 6170 6316, 004 $P 2054
E MEMBER 101- *tF #s0* *1159
THANK YOUR
CITY OF CARMEL -FIRE OEPARTMPNT
705814 AAA -28 PACK E
265361 AA BATTERIES 16.93 E
246380 PUFFS 9.88 E
140251 WISK 2X HE 16.26 E
140251 WISK 2X HE 1 E
124185 THE WORKS 4.6 E'
124185 THE WORKS 4.46 E
769274 MR. CLEAN 6.78 E
931203 FORMULA 409 10,46 E
124185 THE WORKS 4.46 E
303284 SPRAY BOTT 5.68 E
400759 CLOROX ULTRA 7.58 E
658548 WINDEX COMBO 8.53 E
6+004 BOUNTY WHITE 17,22 E
618004 BOUNTY -WHITE 'i 17 .22 F 4
SUB1O1'P_ 168 'r1
TOTAL 158.71
SAMS_D CREDIT 158.71,
P.0, 9 06042009
HCCOUNT 4 1159
APPROVAL ri 000428
CHANGE DUE 0.00
ITEMS SOLD 15
TC# 5366 6326 5563 4155 2840 7
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r r WE VALUE YOUR OPINION
WE WANT To,KtvuW A90U1' YOUR SHOF PING+
FxPEHILr4cE TODAY AT SAM'S CLUB
s Pl a complote,a survey about today's cluh visit at t
y, n 1d ..a9 h i• ..4 et• 2 uG ;ara
htto:Ilwww. survey. srmsclub. cum
IN RE I URN FOR YOUR I IMF YOU COULD RECEIVE
ONE OF FIVE $t001l ':Ai-AS CLUB SHOPrriNG CARDS
You must he IS or olrlrt and a legal resident of the
United States to enter. No purchase necessary to win
To enter without purchase and for official rules visit:
L a r www- entry survey.sams club cum
j a Sweepstake s period ends on the date shown in the
official rules. T
must he ken within TWO weeks
of today.
L sta encuesta tambien se encuentta an espariol en la
pagina de Internet.
THANK YOU
Support. your chi- 1'dren's hospl -tal with
a gtf.t to Children's Miracle Network.
Y 06/04/09 14:54
MEMBER COPY.a#
w •r.._'-'"'°'- -mac., 31 t'.°.,.'^"°
Prescribed 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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
00350958
SAM'S CLUB DIRECT Purchase Order No.
PO BOX 530930 Terms
ATLANTA, GA 30353 -0930 Due Date 7/14/2009
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7/14/2009 005170 $158.71
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
Date Officer
VOUCHER 092.315 WARRANT ALLOWED
00350958 V3E/? IN SUM OF
SAM'S CLUB DIRECT
PO BOX 530930 z
-ATLANTA, GA 30353 -0930 0,0���'�
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
005170 01- 6200 -06 $158.71
Voucher Total $158.71
Cost distribution ledger classification if
claim paid under vehicle highway fund