210316 07/05/2012 CITY OF CARMEL, INDIANA VENDOR: 353565 Page 1 of 1
ONE CIVIC SQUARE CROWN TROPHY CHECK AMOUNT: $166.40
CARMEL, INDIANA 46032 807 W CARMEL DRIVE
i .off `o CARMEL IN 46032 CHECK NUMBER: 210316
CHECK DATE: 715/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4345001 15963 166.40 INTERNAL MATERIALS
CROWN TROPHY Invoice
Date Invoice
807 West Carmel Drive 6/28/2012 15963
Carmel, Indiana 46032
Bill To
Brookshire Golf Course
Brian Ballard
846 -7431
P.O. No. Terms Due Date
6/28/2012
Item Qty Description Rate Amount
2840 -1GF 6 4.5x2.25in Crystal Golf Award 10.95 65.70T
2840 -2GF 5 5.5x2.75in Crystal Golf Award 15.95 79.75T
2840 -3GF 1 6.5x3in Crystal Golf Award 20.95 20.95T
Sales Tax (7.0 5
Thank You For Selecting Crown Trophy For Your Total $1 5 (�(�.q
Awards Recognition Needs Payments /Credits $0.00
Balance Due
Phone Fax E -mail Web Site
317 -818 -9400 317 818 -9200 crowncarmel @sbcglobal.net www.crowntrophy.com
VOUCHER NO. WARRANT NO.
ALLOWED 20
Crown Trophy
IN SUM OF
807 West Carmel Drive
Carmel, IN 46032
$166.40
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1207 I 15963 I 43- 450.01 I $166.40 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
Friday, June 29, 2012
Director, Brookshir Golf Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
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))
06/28/12 I 15963 I Awards I $166.40
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