177321 09/18/2009 CITY OF CARMEL, INDIANA VENDOR: 358825 Page 1 of 1
ONE CIVIC SQUARE MISTER ICE OF INDIANAPOLIS
+r —ts CARMEL, INDIANA 48032 7954 E 88TH ST CHECK AMOUNT: $390.00
INDIANAPOLIS IN 46256 CHECK NUMBER: 177321
CHECK DATE: 9/1512009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBE AMOUNT DESCRIPTION
1207 4353099 42611 390.00 OTHER RENTAL LEASES
t Lease Invoice
Invoice No: 42611
�j Date: 09/22/2009
OF INDIANAPOLIS Due Date: 09/22/2009
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
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: 5- Sep -2009
Invoice Location Account Company Amount Due Date
Tear Off Return With Payment
for proper credit.
i
Prescribed by State Board of fticounfs 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
rfr�. Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
Total 3 90, &D
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
�U.
aD
ON ACCOUNT OF APPROPRIATION FOR
Board Members
Po# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
_�3o -99 3 ,,�m 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
2�
Signatur
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund