210745 07/17/2012 CITY OF CARMEL, INDIANA VENDOR: 00350837 Page 1 of 1
` ONE CIVIC SQUARE ATLAS RESTAURANT SUPPLY
CARMEL, INDIANA 46032 PO BOX 4075 CHECK AMOUNT: $251.70
s a� SOUTH BEND IN 46634-4075 CHECK NUMBER: 210745
CHECK DATE: 7/17/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4350100 879624 251 . 70 BUILDING REPAIRS & MA
52245 STATE RD.'933 NORTH, 2244's"DIVISION ::p; - •
SOUTH BEND,IN 46637 GRAND RAPIDS,MI'49507 ® 0
(574)272-3343•'1-800-552-ATLAS (616)248-2888.1-800-492-8527 ATLAS RESTAURANT SUPPLY
IBEX QAURANT SUP PIY P.O.BOX 4075 7, I k
3329 N.SHADELAND AVE. 929 N.COLISEUM SOUTH BEND, IN 46634-4075
INDIANAPOLIS,IN 46226 FORT WAYNE,IN 46805 %o i
FOOD SERVICE EQUIPMENT&SUPPLIES (317)541-1111•1-800-333-2001 (260)467-1788.1-866-467-1788
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206495 SAME
CITY OF CARMEL D/B;A dy CITY OF CARMEL U/B/A
BROOKSHI:RE GOLF CLUB BROOKSHI RE GOLF CLUB
1210 BROOK SHIRE. PKWY �` 1210 BROOKSH.I RE
0 17.
CARMEL IN 46033 CARMEL IN 46033
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'PAM LISTER . 07/06/12 21 STEVE BEAT 14 DAYS 1 44602:`.•r 0 EPA I ) ROUTE DELIVERY
;j J • •0 ....D D f 'D r `.y 4•r^�`s ;• Doi iAF11 i = s� ,a
N�00�,3A' REF'L. FILTER 2. 000 2. 004 1 . 00' EFL 79. 22 EM 1.,.,'0., f+ 1
REF'L. 'FILTER i#CFS—•81 1 c:--•S 1. 0012 1. 000 � . 00 Elf 93. 26 EM 93. E ,
Date 7l/v Init: �1r :
3 Account # y3 5 ` $
Account # $
Account # $
Account # $
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SECURITY AGREEMENT. Purchaser hereby grants and conveys to Seller a
security interest in the goods described above and their proceeds pursuant to the
terms and conditions contained on the reverse side.of this document: (:
DATE Company;- —r 2 5 1, 7 h
2.71. JIZ Q►0 , 121 1 .,171 . �•
CUSTOMER COPY
By•
Signature c
`'� Title
'~r
i
i
EXCLUSION OF WARRANTIES. THE PURCHASER AND SELLER AGREE THAT THE IMPLIED
WARRANTIES OF MER.CHANTABI.LITY AND FITNESS FOR A PARTICULAR PURPOSE AND
ALL®TILER WARRANTIES EXPRESS OR IMPLIED,ARE EXCLUDED FROM THIS TRANSAC-
TION AND SHALL NOT-APPLY TO THE GOODS SOLD, PROVIDED HOWEVER;THAT THIS
EXCLUSION OF WARRANTIES APPLIES ONLY TO SELLER AND THAT THE GOODS SOLD
PURSUANT TO THIS TRANSACTION A-RE OR MAY BE SUBJECT TO THE WARRANTIES, EX-
PRESS OR IMPLIED, GIVEN BY THE MANUFACTURER THEREOF.
Purchaser agrees to purchase the above described goods and pay Atlas Restaurant Supply, Inc. (Seller) the
total price stated herein for the above described goods,including sales tax, in accordance with the Sale Terms.
Sale Terns are net cash,seven (7),days after delivery, with interest thereon at the rate of one and one half
percent (1'/2% per month.on the unpaid total price, commencing seven (7) days delivery of the described
goods for each month or portion thereof during which an outstanding balance of the total price remains. Pur-
chaser assumes all risk of darnages.or destruction to the goods upon delivery. Purchaser agrees to pay Seller's
reasonable attorney's fees and costs of collection of any amounjui ot.p.atd.t�vh.eia 7.Purchase agrees'ihavno
return of the goods sold hereunder may be made to Seller without express writn approval of that
Seller may charge a reasonable stocking fee for all goods so'feti%mdd.
SE CURRTIY AGREEMENT. Purchaser hereby grants and conveys to Seller a,security interest in and to,the �
described. goods, and in and to the proceeds thereon, to secure.-the-payment ofPurc,haser--for-tyle'08 ,'sold
hereunder. Purchaser authorizes Seller to execute on tis behalf and file any financing statements,q'ggmed,nec-
essary by Seller to perfect its security interest in said goods. Purchaser war"rarits that°the goods will be main-
tained in good condition and repair. The failure to pay when due of any amount payable here under shall.con-
stitute a default under this agreement. Upon default, Seller have and may exercise all.the rights and remedies
of a secured party under the Uniform Commercial Code or any other applicable law.
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))
07/06/12 879624 Filters $251.70
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
Atlas Restaurant Supply
IN SUM OF $
P.O. Box 4075
South Bend, IN 46634-4075
$251.70
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1207 I 879624 I 43-501.00 I $251.70 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, July 10, 2012
Director, Brookshire off Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund