211763 08/14/2012 CITY OF CARMEL, INDIANA VENDOR: 359590 Page 1 of 1
0 ONE CIVIC SQUARE H2 GOLF COMPANY
CARMEL, INDIANA 46032 3435 BRIAR CREEK LANE CHECK AMOUNT: $267.16
CARMEL IN 46033 CHECK NUMBER: 211763
CHECK DATE: 8/14/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4356006 2836 267 . 16 GOLF SOFTGOODS
H2 Golf Company, LLC Invoice
3435 Briar Creek Lane
Carmel, IN 46033 Date Invoice#
GOLD
800-466-2305 7/31/2012 2836
Bill To Ship To
Brookshire Golf Club Brookshire Golf Club
12120 Brookshire Parkway 12120 Brookshire Parkway
Carmel, IN 46033 Carmel. IN 46033
Rep P.O. No. Terms
MH Net 30
H2 Item Description Invoiced Unit Price Amount
11 102-Peg#2 2 3/4'Deluxe 50 pk WhiteTees Peg 42 6 1.55 9.30
11 103-Peg 43 2 3/4'Deluxe 50 pk Natural Tees Peg#3 6 1.55 9.30
11 104-Peg#4 2 3/4'Deluxe 50 pk Mixed..Peg#4 6 1.55 9.30
11 109-Peg#9 3 1/4'Deluxe 50 pk white..Peg#9 6 2.05 12.30
1 1 1 10-Peg#10 3 1/4'Deluxe 50 pk Natural..Peg#10 6 2.05 12.30
1 1 1 1 1-Peg#1 1 3 1/4'Deluxe 50 pk Mixed..Peg#1 1 6 2.05 12.30
11112-Peg#12 3 1/4'Deluxe 100 pk White..Peg#12 6 3.05 18.30
1 1 1 13-Peg#13 3 1/4'Deluxe 100 pk Natural..Peg#13 6 3.05 18.30
1 1 1 15-Peg#15 4'Deluxe 50 pk White..Peg#15 6 205 12.30
1 1 1 16-Peg#16 4'Deluxe 50 pk natural..Peg#16 6 2.05 12.30
1 1 1 19-Peg#19 2 3/4'Eco Endurance 50pk..Peg#19 6 3.05 18.30
1 1121-Peg#21 3 1/4'Eco RRT 50 pk White..Peg#21 6 3.55 21.30
11 122-Peg#38 2 3/4'Tour Stripe 50 1'k White..Peg#38 6 3.05 18.30
11 123-Peg#39 3 1/4'Tour Stripe 50pk White..Peg#39 6 3.05 18.30
21119-Peg#40 Deluxe Rachet Spike Wrench..Peg#40 6 5.00 30.00
PEG#42-OUT OF STOCK
11129-Peg#52 Eco Tees RTT 2 3/4"White 30 count 6 3.00 18.00
5hipnin2_Eee. 1 16.96 16.96
Thank you for your business! Total $267.16
*All return goods will be inspected by our warehouse staff prior to issuing a credit. Sales Tax (O.O%) $0.00
Our terms are net 30 days.A 1 1/2%late charge per month will be added on all past due
invoices. Payments/Credits $0.00
Balance Due $267.16
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))
07/31/12 2836 Soft Goods $267.16
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
H2 Golf Company, LLC
IN SUM OF $
3435 Brair Creek Lane
Carmel, IN 46033
$267.16
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. I ACCT#/TITLE AMOUNT Board Members
1207 I 2836 I 43-560.06 ( $267.16 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
Wednesday, August 08, 2012
Director, BrookshirOGolf Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund