178291 10/14/2009 CITY OF CARMEL, INDIANA VENDOR: 358825 Page 1 of 1
f ONE CIVIC SQUARE MISTER ICE OF INDIANAPOLIS CHECK AMOUNT: $390.00
t CARMEL, INDIANA 46032 7954 E 88TH ST
INDIANAPOLIS IN 46256 CHECK NUMBER: 178291
CHECK DATE: 10/1412009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4353099 44119 390.00 OTHER RENTAL LEASES
Leese Invoice
Invoice No: 44119
Date: 10/22/2009
OF INDIANAPOLIS Due Date: 1022/2009
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
ItemNo 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: 6- Oct -2009
Invoice Location Account Company Amount Due Date
Tear Off Return With Payment
for proper credit.
Vv
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
g4 j�,y�}J S Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
Total 61D
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
ON ACCOUNT OF APPROPRIATION FOR
cz�tj&g�q/
Board Members
Po# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice or
6 7 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
2 0 D `1
�J
S' nature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund