213510 10/09/2012 CITY OF CARMEL, INDIANA VENDOR: 359984 Page 1 of 1
ONE CIVIC SQUARE INDIANA GOLF CAR
CARMEL, INDIANA 46032 1770 B EAST 266TH STREET CHECK AMOUNT: $43.20
? ARCADIA IN 46030
CHECK NUMBER: 213510
CHECK DATE: 10/9/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4350000 4518 43 . 20 EQUIPMENT REPAIRS & M
Indiana Golf Car,Inc. Invoice
1770 B E 266th
Arcadia, IN 46030 Date Invoice#
9/29/2012 4518
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 9/29/2012
Quantity Item Code Description Price Each Amount
1 _102562701 HIP RESTRAINT,PREC,LH 43.20 43.20
ate Init. -
ccount# a3 s-oo $
ccount # $
ccount# $
ccount# $
Total $43.20
VOUCHER NO. WARRANT NO.
ALLOWED 20
Indiana Golf Car, Inc.
IN SUM OF $
1770 B E 266th
Arcadia, IN 46030
$43.20
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT
Board Members
1207 I 4518 1 43-500.00 f S43.20 I hereby certify that the attached invoice(s), or
1 I 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, October 02, 2012
Director, Bro shire 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))
09/29/12 I 4518 Repair Parts I $43.20
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