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180491 12/16/2009 CITY OF CARMEL, INDIANA VENDOR: 358825 Page 1 of 1 0 ONE CIVIC SQUARE MISTER ICE OF INDIANAPOLIS CARMEL, INDIANA 46032 7954 E 88TH ST CHECK AMOUNT: $390.00 INDIANAPOLIS IN 46256 CHECK NUMBER: 180491 CHECK DATE: 12/16/2009 DEPARTMENT A PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1207 4353099 47088 390.00 OTHER RENTAL LEASES Lease Invoice Invoice No: 47088 Date: 12/2212009 OF INDIANAPOLIS Due Date: 12/22/2009 Terms: Due Upon Receipt 7954 East 88th St. Cust PO: Indianapolis, IN 46256 Reference: Monthly Service Tel. 317- 849 -4466 Lease 50993 Fax. 317 -578 -0750 AcctNo: 50993 Billing Address: Location Address: Brookshire Golf Club Brookshire Golf Club Carmel Redevelopment Commissio 12120 Brookshire Parkway 12120 Brookshire Pkwy CARMEL, IN 46033 CARMEL, IN 46033 1temNo Description Qty Unit Price Extended OE -LEASE Full Service Lease for Outside 1.00 MONTH $195.00 $195.00 Clubhouse Ice Machine OE -LEASE Full Service Lease for 126th St. Pump 1.00 MONTH $195.00 $195.00 House Outside Ice Machine. Due on the 22nd of every month Blank Acount Numbers indicate invoices prior to June 2008 Open Invoices as of: 4 -Dec -2009 Invoice Location Account# Company Amount Due Date Tear Off Return With Payment for proper credit. Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995) CITY OF CARMEL �Qn 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 D Purchase Order No. Terms yt2`�L�� Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) Total 3 go 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 �rg.1 ON ACCOUNT OF APPROPRIATION FOR Board Members PO# or INVOICE NO. ACCT /TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or d If -9 L 390, 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 Cl2C 4 20 Signatur Cost distribution ledger classification if T itle claim paid motor vehicle highway fund