211540 07/31/2012 CITY OF CARMEL, INDIANA VENDOR: 359984 Page 1 of 1
ONE CIVIC SQUARE INDIANA GOLF CAR CHECK AMOUNT: $614.00
CARMEL, INDIANA 46032 1770 B EAST 266TH STREET
ARCADIA IN 46030 CHECK NUMBER: 211540
CHECK DATE: 7/31/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4350000 4169 114 .40 EQUIPMENT REPAIRS & M
1207 4350000 4193 499 . 60 EQUIPMENT REPAIRS & M
Indiana Golf Car, Inc. Invoice
1770 B E 266th
Date Invoice#
Arcadia, IN 46030
7/20/2012 4193
Bill To Ship To
BROOKSHIRE G.C. BROOKSHIRE G.C.
12120 BROOKSHIRE PKWY. 12120 BROOKSHIRE PKWY.
CARMEL,IN 46033 CARMEL,IN 46033
P.O. Number Terms Rep Ship Via F.O.B. Project
Net 30 7/20/2012
Quantity Item Code Description Price Each Amount
2 MISC EZGO PARTS BRAKE SHOES 192.00 384.00
2 MISC EZGO PARTS REAR SHOCK 48.00 96.00
2 MISC EZGO PARTS SHOCK BUSHING KIT 9.80 19.60
THESE PARTS WERE PICKED UP BY JEFF STEWART
WITH THE CITY OF CARMEL.
ate 1b Init.
Account #
ccount # $
ccount # $
ccount # $
Total $499.60
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))
07/20/12 4193 Repair Parts $499.60
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
Indiana Golf Car, Inc.
IN SUM OF $
1770 B E 266th
Arcadia, IN 46030
$499.60
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1207 I 4193 I 43-500.00 I $499.60 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 24, 2012
1
Director, Brookshirql Golf Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Indiana Golf Car, Inc. Invoice
1770 B E 266th
Arcadia, IN 46030 Date Invoice#
7/16/2012 4169
Bill To Ship To
BROOKSHIRE G.C. BROOKSHIRE G.C.
12120 BROOKSHIRE PKWY. 12120 BROOKSHIRE PKWY.
CARMEL,IN 46033 CARMEL, IN 46033
P.O. Number Terms Rep Ship Via F.O.B. Project
RUSSELL Net 30 7/16/2012
Quantity Item Code Description Price Each Amount
1 102273701 PD2 FUSE ASM 1 8.60 18.60
2 103528801 KIT,BRAKE CABLE,PREC UPGRADE 47.90 95.80
J �
ate ! In it.
Account #—L/-5 $
Account # $
Account #..._:^.. $:...-- -
Account # $
Total $114.40
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))
07/16/12 4169 Repair Parts $114.40
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
Indiana Golf Car, Inc.
IN SUM OF $
1770 B E 266th
Arcadia, IN 46030
$114.40
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1207 I 4169 I 43-500.00 I $114.40 I 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, July 20, 2012
AG
Director, Brookshire Gol lub
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund