208864 05/10/2012 CITY OF CARMEL, INDIANA VENDOR: 359498 Page 1 of 1
ONE CIVIC SQUARE SHELBY MATERIALS
CARMEL, INDIANA 46032 P o BOX 242 CHECK AMOUNT: $711.59
SHELBYVILLE IN 46176
CHECK NUMBER: 208864
CHECK DATE: 5/10/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4236100 413173 711.59 SAND
INVOICE
CUSTOMER' INVOICE,NO
TM
M A T E R I A L S
BR001 04/21/2012 413173 1
The Concrete and Aggregate Experts "0
317 398 -4485 FAX 317 398 -2727
BROOKSHIRE GOLF CLUB
CITY OF CARMEL Send remittance to:
12120 BROOKSHIRE PKWY Shelby Materials
P.O. Box 242
CARMEL IN 46033 Please attach top part Shelbyville, Indiana 46176
with your remittance. Detach Here
JOB,NUMBER JOB LOCATION ,4DDRES3 PER T AX
DATE TICKET N,O. QUANTITY' UNIT DESCRIPTION PRICE UNIT' TOTAL'
000201 GOLF COURSE
PO NUMBER: G -98
04/20 032 483252 22.80 TN TOP DRESSING SAND 22.250 507.30
04/20 032 483252 22.80 TN DELIVERY CHARGE 8.000 182.40
04/20 032 483252_ 2.74 TN FUEL SURCHARGE 8.000 21.89
JOB TOTAL LINE 711.59
�I
Date Init. )z
Account ao3
Account
Account
Account
INVOICE 711.59
AM:OUNT:DUE
TERMS: NET 30 DAYS -THERE WILL BE A FINANCE CHARGE OF 2.00% PER MONTH (24% PER
ANNUM) ON ALL ACCOUNTS PAST 30 DAYS. ALL ACCOUNTS, WITHOUT PRIOR APPROVAL,
WHICH HAVE OUTSTANDING BALANCES OVER 90 DAYS, WILL BE TEMPORARILY PLACED ON
QO.D.THE ACCOUNT WILL REMAIN ON A C.O.D. BASIS UNTIL BALANCE IS PAID OR SUITABLE a
ARRANGEMENTS ARE MADE WITH THE CREDIT DEPARTMENT, ALL ACCOUNTS TURNED
OVER FOR COLLECTION WILL INCUR REASONABLE ATTORNEY FEES AND COURT COSTS TO
BE PAID BY THE PURCHASER WITH PROPER VENUE AS SHELBY COUNTY.
CC750392 (4101) Shelby Supply (Rev. 11/08)
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 service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
04/21/12 413173 Sand $711.59
1 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
Shelby Materials
IN SUM OF
P.O. Box 242
Shelbyville, IN 46176
$711.59
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO# Dept. INVOICE NO. I ACCT #/TITLE AMOUNT Board Members
1207 I 413173 I 42- 361.00 I $711.59 1 hereby certify that the attached invoice(s), or
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
Tuesday, May 01, 2012
Director, Brooks t e Golf Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund