214685 11/20/2012 CITY OF CARMEL, INDIANA VENDOR: 358995 Page 1 of 1
ONE CIVIC SQUARE I G A/P G A INC
CARMEL, INDIANA 46032 PO BOX 516
CHECK AMOUNT: $259.00
FRANKLIN IN 46131 CHECK NUMBER: 214685
CHECK DATE: 11/20/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4355300 006238 259 . 00 ORGANIZATION & MEMBER
INDIANA GOLF BILL DATE DUE DATE
11/09/2012 11/09/2012
i BILLING INQUIRIES PAY THIS AMOUNT AMOUNT ENCLOSED
' 317-738-9696 $259.00
Promoting the Game,Honoring the Tradition_
❑ VISA ❑ ❑ AMEX
Make checks payable to: IGA-PGA, Inc. Card Number Exp.Date
Signature Security Code
Indiana Golf Office Brookshire Golf Club
PO Box 516 12120 Brookshire Pkwy
Franklin, IN 46131 Carmel, IN 46033-3314
Please Detach And Return Top Portion With Your Payment
STATEMENT
CLUB NAME BILL DATE DUE DATE
Brookshire Golf Club 11/09/2012 11/09/2012
REF# DESCRIPTION FEE
006238 New Members 14 Standard members @ $18.50 $259.00
006239 Existing members 181 Standard members @ $0.00 $0.00
e
If you have questions about your account, call 317-738-9696. $259.00
Message(s):
This invoice represents all new members added since the previous billing on June 2, 2012. Please remit upon receipt.
Final revision for 2012 is November 15th.
Thank you for your support of IGA-PGA.
Judy
- - Indiana-Golf — - - _ __ lue olf'Q�_
INI,UVAVW SYSTEMS FOR
VOUCHER NO. WARRANT NO.
ALLOWED 20
IGA-PGA
Judy Deiwert IN SUM OF $
P:O. Box 516
Franklin, IN 46131
$259.00
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1207 I 006238 I 43-553.00 I $259.00 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, November 15, 2012
Director, Brookshire If 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))
11/09/12 006238 Dues $259.00
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