213615 10/09/2012 CITY OF CARMEL, INDIANA VENDOR: 358941 Page 1 of 1
ONE CIVIC SQUARE PETTY CASH-BROOKSHIRE GOLF COT�g
CARMEL, INDIANA 46032 C/O PAM LISTER CHECK AMOUNT: $9.99
?� CHECK NUMBER: 213615
CHECK DATE: 10/9/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239099 9 . 99 OTHER MISCELLANOUS
O ' MALIA #206
41'55 E. 126TH ST.
CARMEL, IN 46033
(317)844-4372
2900 PAW CAT FO DRY BLN"PL' 11 .99 T
**** TAX .89 BAL 12.83
CUSTOMER NUMBER 98317896100
SC 3081 PAW CAT FD DRY BLN 2.00-T
**** TAX .70 BAL 10.69
� r
CASH 20.00
CHANGE 9.31
TOTAL NUMBER OF ITEMS SOLD = 1
10/02/17 12:53 PM 0206 09 0036.143
YOUR-CASHIER WAS CHASE
'YOU SAVED
$ 2 . 00 ( 17% )
ON YOUR ORDER TODAY
YOUR SAVINGS ******#+r**
' COUPON PLUS SAVINGS 2.00
TOTAL. SAVINGS (17%) $ 2.00
YOUR SAVINGS
THANK 'YOU FOR SHOPPING
d O ' MALIA
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$0.00 in 2011 .
You have saved
$16.97 in 2012.
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VOUCHER NO. WARRANT NO.
ALLOWED 20
Petty Cash
IN SUM OF $
$9.99
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1207 I O'Malia I 42-390.99 I $9.99 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
Thursday, October 04, 2012
Director, Broo 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))
10/02/12 I O'Malia I Cat Food I $9.99
I 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