214797 11/20/2012 CITY OF CARMEL, INDIANA VENDOR: 358593 Page 1 of 1
ONE CIVIC SQUARE REPUBLIC WASTE SERVICES OF INDIA CHECK AMOUNT: $3,983.44
CARMEL, INDIANA 46032 PO BOX 9001099
LOUISVILLE KY 40290-1099 CHECK NUMBER: 214797
CHECK DATE: 11/20/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4350101 150 . 00"`0761-001382516
1205 4350101 105 . 00-0791-001377371
1207 4350101 407 . 00 0761-001385586
651 5023990 200 . 730761-001382518
651 5023990 364 . 01-0761-001382519
651 5023990 2 , 756 . 70-0761-001387430
I
-----------------------
------------------------------------------------------------
4R'A --
REPUBLIC CAR M
EL CLAY Y PA R K S a-4 sFAVicFS
832 Langsdale Ave Invoice
Indianapolis,IN 46202-1150
Page 1 of 2
Payments/Adjustments
,t �• � Date
Descs tat_°n
„0 10120 Payment-Thank eference
J�IU ank You 3 0761-1410948 Amount 213— g�
Account Number Current Invoice Charges -$150.00
Invoke Date October 25,2012
Invoice Number 0761-001382516 Carm el Clay Park's 1411E 116th St (L1) CSA 94811711
Previous Balance Carmel,IN
Payments/Adjustments $150.00
Unpaid Balance $150.00 2-Front Load(8 Yd) Scheduled Service (Si)
Current Invoice Charges $1$0.00
50.00 Date ?D__-Dtlon
10/25 Basic Service 11/01/12-11/30/12 Reference quanti
t1C Unit Pri00 ce Amount
Current 150.
ent Invoice Charges $150.00
° $150.00
o
$150.00
Due By: 11/14/12
a o � "o
Customer Service
.(317)917-7300 5 NOV 0 2,201
2
BY:
o o
Effective 4/76/2012:SERVICE INTERRUPTION nl Irchase
POLICY CHANGE All accounts with a balance over L''�Cr'1 t,
60 days will experience a service interruption unless ,Orl V`�1p(J1�_,{��_p
Prior arrangements are made. P�• # �—r l_A,Q.
}
� 3_b
Purchaser
f+i Proval 'Date_�i
Data
'f `0;GUKREN7
150.00 0.00 64 UAY5 x % r�� ,,:9.0+x.00
To pay on-line or sign up for
convenient auto pay, go to: A A o.00 o.00
www.disposal.com ' Visit our upfo e,our con isposal.com to make your payment electronically
or to sign up for our convenient automatic payment plan.
• Please see reverse side for terms and conditions
- - ---------------------------
--- ------ Page 2 of 2
3-0761-1410948 payment, you
CARMEL CLAY PARK'S guidelines, when you provide a check as from our account or to
Check Processing: In accordance with Federal Reserve Board g. our check to make an electronic fun dl not
authorize us to use information from your checWhen weeuse nfo mationcfrom yfundeceiveerour payment and you autho payment as a check transaction
process the paY be withdrawn from your account as soon as the same day we r
transfer, funds may your financial institution. For further information visit: www electronicpayments.org and click
receive your check back from yo
on the Check Conversion tab. h the
responsible for all charges, fees and taxes through
If service is canceled during a billing cycle, the customer will remain cusp I if it is contrary to a
billin cycle. This provision will not apply
le.There will be no proration of billing, and the customer will not be entitled to aoeis oaherwisep
end of the billing cyc licable to this account
between the notice of ementatmun cripahcont act or other written contract app
current franchise agre
prohibited by law. check, credit card or money order,
an reserves the right to require that payment for services be made only by
The Company applicable law.
unless otherwise required by contract or app
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of 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.
358593 Republic Services # 761 Terms
P.O. Box 9001099
Louisville, KY 40290-1099
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO# Amount
10/25/12 761001382516 Dumpster AO Nov'12 $ 150.00
Total $ 150.00
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
120
Clerk-Treasurer
Voucher No. Warrant No.
358593 Republic Services#761 Allowed 20
P.O. Box 9001099
Louisville, KY 40290-1099
In Sum of$
$ 150.00
ON ACCOUNT OF APPROPRIATION FOR
101 -General Fund
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1125 761001382516 4350101 $ 150.00 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
15-Nov 2012
Signature
$ 150.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
�D
REPUBLIC CITY OF CARMEL �L�(�� J� Invoice
ly� SERVICES Page 1 of 2
632 Langsdale Ave I
Indianapolis,IN 46202-1150
Payments/Adjustments
Date Description Reference Amount
10/20 Payment-Thank You 213637 -$105.00
u
Account Number 3-0761-0034742 Current Invoice Charges
Invoice Date October 25,2012 City Hall 1 Civic Sq (1-1) CSA 002763
Invoice Number 0761-001377371 Carmel,IN
Previous Balance $105.00
Payments/Adjustments -$105.00 1 -Front Load(6 Yd) Scheduled Service (S1)
Unpaid Balance $0.00 Date Description Reference Quantity Unit Price Amount
Current Invoice Charges $105.00 10/25 Basic Service 11/01/12-11/30/12 $105.00 $105.00
Current Invoice Charges $105.00
$105.00
Due By: 11/14/12
Customer Service (317)917-7300
Effective 4/16/2012:SERVICE INTERRUPTION NOV 1 9 2012
POLICY CHANGE All accounts with a balance over
60 days will experience a service interruption unless
prior arrangements are made.
By
. Gl1RREN't:.. ",. 11, 30%3AYS�i"r'.. < =60DAY,S .. .;:.w'%x 90 .DAYSM 7
105.00 0.00 0.00 0.00
To pay on-line or sign up for
convenient auto pay, go to: A A • Visit our website,www.disposal.com to make your payment electronically
www.disposal.com or to sign up for our convenient automatic payment plan.
• Please see reverse side for terms and conditions
CITY OF CARMEL 3-0761-0034742 Page 2 of 2
Check Processing: In accordance with Federal Reserve Board guidelines, when you provide a check as payment, you
authorize us to use information from your check to make a one-time electronic fund transfer from your account or to
process the payment as a check transaction. When we use information from your check to make an electronic fund
transfer, funds may be withdrawn from your account as soon as the same day we receive your payment and you will not
receive your check back from your financial institution. For further information visit: www.electronicpayments.org and click
on the Check Conversion tab.
If service is canceled during a billing cycle, the customer will remain responsible for all charges, fees and taxes through the
end of the billing cycle. There will be no proration of billing, and the customer will not be entitled to a refund for the period
between the notice of termination and the end of the current billing cycle. This provision will not apply if it is contrary to a
current franchise agreement, municipal contract, or other written contract applicable to this account or is otherwise
prohibited by law.
The Company reserves the right to require that payment for services be made only by check, credit card or money order,
unless otherwise required by contract or applicable law.
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))
10/25/12 0761-001377371 $105.00
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
Republic Services #761
IN SUM OF $
PO Box 9001099
Louisville, KY 40290-1099
$105.00
ON ACCOUNT OF APPROPRIATION FOR
Administration Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
26460 0761-001377371 46-501.01 $105.00
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
Monday, November 19, 2012
Director, Administration
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
REPUBLIC CARMEL UTILITIES Invoice
SERVICES
Page 1 of 2
832 Langsdale Ave
Indianapolis,IN 46202-1150
Payments/Adjustments
Date Description Reference Amount
10120 Payment-Thank You 213637 -$364.01
- ;. ,
Account Number 3-0761-1410955 Current Invoice Charges
Invoice Date October 25,2012 Carmel Utilities 9609 Hazel Dell Parkway (L1)
Invoice Number 0761-001382519 Carmel,IN
Previous Balance $364.01
Payments/Adjustments -$364.01 14-Front Load(2 Yd) Scheduled Service (S1)
Unpaid Balance $0.00 Date Description Reference Quantity Unit Price Amount
Current Invoice Charges $364.01 1 10/25 Basic Service 11/01/12-11/30/12 $364.01 $364.01
Current Invoice Charges $364.01
$364.01
Due By: 11/14/12
o .w o.
Customer Service (317)917-7300
00 a o
Effective 4/16/2012:SERVICE INTERRUPTION
POLICY CHANGE All accounts with a balance over
60 days will experience a service interruption unless
prior arrangements are made.
WCllRREN CV s ,<, =30 t3AYS
364.01 0.00, 0.00 0.00
To pay on-line or sign up for
convenient auto pay, go to: A A • Visit our website,www.disposal.com to make your payment electronically
www.disposal.com or to sign up for our convenient automatic payment plan.
• Please see reverse side for terms and conditions
CARMEL UTILITIES 3-0761-1410955 Page 1 of z
Check Processing: In accordance with Federal Reserve Board guidelines, when you provide a check as payment, you
authorize us to use information from your check to make a one-time electronic fund transfer from your account or to
process the payment as a check transaction. When we use information from your check to make an electronic fund
transfer, funds may be withdrawn from your account as soon as the same day we receive your payment and you will not
receive your check back from your financial institution. For further information visit: www.electronicpayments.org and click
on the Check Conversion tab.
If service is canceled during a billing cycle, the customer will remain responsible for all charges, fees and taxes through the
end of the billing cycle. There will be no proration of billing, and the customer will not be entitled to a refund for the period
between the notice of termination and the end of the current billing cycle. This provision will not apply if it is contrary to a
current franchise agreement, municipal contract, or other written contract applicable to this account or is otherwise
prohibited by law.
The Company reserves the right to require that payment for services be made only by check, credit card or money order,
unless otherwise required by contract or applicable law.
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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
358593
REPUBLIC WASTE SERVICES OF INDIANA Purchase Order No.
PO BOX 9001099 Terms
LOUISVILLE, KY 40290-1099 Due Date 11/14/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/14/201: 0761-001382 $364.01
hereby certify that the attached invoice(s), or bill(s) is (are) true and
:orrect and I have audited same in accordance with IC 5-11-10-1.6
Date Officer
VOUCHER # 126149 WARRANT # ALLOWED
358593 IN SUM OF $
REPUBLIC WASTE SERVICES OF INDI
PO BOX 9001099
LOUISVILLE, KY 40290-1099
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
0761-001382E 01-7362-05 $364.01
Voucher Total $364.01
Cost distribution ledger classification if
claim paid under vehicle highway fund
�R�REPUBLOC CARMEL UTILITIES Invoice
fy� SERVICES
Page 1 of 2
832 Langsdale Ave
Indianapolis,IN 46202-1150
Payments/Adjustments
Date Description Reference Amount
10/20 Payment-Thank You 213637 -$200.73
e
Account Number 3-0761-1410954 Current Invoice Charges
Invoice Date October 25,2012 Carmel Utilities 901 N Range Line Rd (L1)
Invoice Number 0761-001382518 Carmel,IN
Previous Balance $200.73
Payments/Adjustments -$200.73 1 -Front Load(8 Yd) Scheduled Service (S1)
Unpaid Balance $0.00 Date Description Reference Quantity Unit Price Amount
Current Invoice Charges $200.73 10/25 Basic Service 11/01/12-11/30/12 $143.79 $143.79
1 -Front Load(2 Yd) Scheduled Service (S2)
Date Description Reference Quantity Unit Price Amount
° 10/25 Basic Service 11/01/12-11/30/12 $56.94 $56.94
$200,73 Current Invoice Charges $200.73
Due By: 11/14/12
Customer Service (317)917-7300
00 0 0
Effective 4/16/2012:SERVICE INTERRUPTION
POLICY CHANGE All accounts with a balance over
60 days will experience a service interruption unless
prior arrangements are made.
CURRENT '=x .. 'MI,
, . . DAYS
200.73 0.00 0.00 0.00
To pay on-line or sign up for
convenient auto pay, go to: A A • Visit our website,www.disposal.com to make your payment electronically
www.disposal.com or to sign up for our convenient automatic payment plan.
• Please see reverse side for terms and conditions
CARMEL UTILITIES 3-0761-1410954 Page 2 of 2
Check Processing: In accordance with Federal Reserve Board guidelines, when you provide a check as payment, you
authorize us to use information from your check to make a one-time electronic fund transfer from your account or to
process the payment as a check transaction. When we use information from your check to make an electronic fund
transfer, funds may be withdrawn from your account as soon as the same day we receive your payment and you will not
receive your check back from your financial institution. For further information visit: www.electronicpayments.org and click
on the Check Conversion tab.
If service is canceled during a billing cycle, the customer will remain responsible for all charges, fees and taxes through the
end of the billing cycle. There will be no proration of billing, and the customer will not be entitled to a refund for the period
between the notice of termination and the end of the current billing cycle. This provision will not apply if it is contrary to a
current franchise agreement, municipal contract, or other written contract applicable to this account or is otherwise
prohibited by law.
The Company reserves the right to require that payment for services be made only by check, credit card or money order,
unless otherwise required by contract or applicable law.
�RAREPUBLIC CARMEL UTILITIES HHW Invoice
SERVICES
Page 1 of 3
832 Langsdale Ave
Indianapolis,IN 46202-1150
Payments/Adjustments
Date Description Reference Amount
°
10/06 Payment-Thank You 213157 -$2,603.55
Account Number 3-0761-1163292 Current Invoice Charges
Invoice Date October 31,2012 Carmel Utilities Hhw 901 N Range Line Rd (1_7) CSA 3292121010
Invoice Number 0761-001387430 Carmel,IN
Previous Balance $4,900.80
Payments/Adjustments -$2,603.55 1 -Hooklift(30 Yd) Scheduled Service (S1) Comingled
Unpaid Balance $2,297.25 Date Description Reference Quantity Unit Price Amount
Current Invoice Charges $2,756.70 10/02 Basic Service 1.0000 $153.15 $153.15
Receipt Number 3853
10/04 Basic Service 1.0000 $153.15 $153.15
Receipt Number 3853
10106 Basic Service Sales Bm 1.0000 $153.15 $153.15
° Reute pt Numbci 29655
$5,053.95 10/06 Basic Service Sales Bm 1.0000 $153.15 $153.15
Receipt Number 30121
Due By: 11/20/12 10/11 Basic Service 1.0000 $153.15 $153.15
Receipt Number 3853
@aqm 0 0 10/16 Basic Service 1.0000 $153.15 $153.15
Receipt Number 3853
Customer Service (317)917-7300 10/18 Basic Service 1.0000 $153.15 $153.15
Receipt Number 3853
10/23 Basic Service 1.0000 $153.15 $153.15
Receipt Number 3853
10/25 Basic Service 1.0000 $153.15 $153.15
0 0 0 Receipt Number 3853
Effective 4/1612012:SERVICE INTERRUPTION 10/31 Bask Service 1.0000 $153.15 $153.15
POLICY CHANGE All accounts with a balance over Receipt Number 3853
60 days will experience a service interruption unless
prior arrangements are made. 1 -Rolloff(30 Yd) Scheduled Service (S3) Comingled
Date Description Reference Quantity Unit Price Amount
10/02 Basic Service 1.0000 $153.15 $153.15
Receipt Number 5831
10/04 Basic Service 1.0000 $153.15 $153.15
Receipt Number 5831
CURRENT Itt 0j'DAYSs 6DxDAYS A : .. 9,0±DAY,
2,756.70 2,297.25 0.00 0.00
To pay on-line or sign up for :Past Due Balance $2,297.25
convenient auto pay, go to: DA Visit our website,www.disposal.com to make your payment electronically
CARMEL UTILITIES HHW 3-0761-1163292 Page 2 of 3
Check Processing: In accordance with Federal Reserve Board guidelines, when you provide a check as payment, you
authorize us to use information from your check to make a one-time electronic fund transfer from your account or to
process the payment as a check transaction. When we use information from your check to make an electronic fund
transfer, funds may be withdrawn from your account as soon as the same day we receive your payment and you will not
receive your check back from your financial institution. For further information visit: www.electronicpayments.org and click
on the Check Conversion tab.
If service is canceled during a billing cycle, the customer will remain responsible for all charges, fees and taxes through the
end of the billing cycle. There will be no proration of billing, and the customer will not be entitled to a refund for the period
between the notice of termination and the end of the current billing cycle. This provision will not apply if it is contrary to a
current franchise agreement, municipal contract, or other written contract applicable to this account or is otherwise
prohibited by law.
The Company reserves the right to require that payment for services be made only by check, credit card or money order,
unless otherwise required by contract or applicable law.
000862-000002-000002-001724 2309597 2240ST03 1 3
Page 3 of 3
CARMEL UTILITIES HHW Republic Services #761
R, Account Number 3-0761-1163292
5; +REPUBLIC Invoice Date October 31,2012 832 Langsdale Ave
1f►� SERVICES Invoice Number 0761-001387430 Indianapolis, IN 46202-1150
Current Invoice Charges
Date Description Reference Quantity Unit Price Amount
10/11 Basic Service 1.0000 $153.15 $153.15
Receipt Number 5831
10/16 Basic Service 1.0000 $153.15 $153.15
Receipt Number 5831
10/18 Basic Service 1.0000 $153.15 $153.15
Receipt Number 5831
10/23 Basic Service 1.0000 $153.15 $153.15
Receipt Number 5831
10/25 Basic Service 1.0000 $153.15 $153.15
Receipt Number 5831
10/30 Basic Service 1.0000 $153.15 $153.15
Receipt Number 5831
Current Invoice Charges $2,756.70
I
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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
358593
REPUBLIC WASTE SERVICES OF INDIANA Purchase Order No.
PO BOX 9001099 Terms
LOUISVILLE, KY 40290-1099 Due Date 11/14/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/14/201, 0761001382: $200.73
1 hereby certify that the attached invoice(s), or bill(s) is (are) true and
:orrect and I have audited same in accordance with IC 5-11-10-1.6
Date Officer
VOUCHER # 126168 WARRANT # ALLOWED
358593 IN SUM OF $
REPUBLIC WASTE SERVICES OF INDI
PO BOX 9001099
LOUISVILLE, KY 40290-1099
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
POD# INV# ACCT# AMOUNT Audit Trail Code
07610013825 01-736H-08 $200.73
(37b1�13$7y '' 27500
51y3
Voucher Total $2
Cost distribution ledger classification if
claim paid under vehicle highway fund
�R�AREPUBLIC CITY OF CARMEL BROOKSHIRE GOLF Invoice
44 SERVICES
Page 1 of 2
832 Langsdale Ave
Indianapolis,IN 46202-1150
Payments/Adjustments
Date Description Reference Amount
10/06 Payment-Thank You 213157 -$132.00
Account Number 3-0761-0035460 Current Invoice Charges
Invoice Date October 31,2012 Brookshire Golf Course 12120 Brookshire Pkwy (Li) CSA 002765
Invoice Number 0761-001385586 Carmel,IN
Previous Balance $264.00
Payments/Adjustments -$132.00 1 -Front Load(8 Yd) Scheduled Service (S1)
Unpaid Balance $132.00 Date Description Reference Quantity Unit Price Amount
Current Invoice Charges $407.00 10/31 Basic Service 11/01/12-11/30/12 $132.00 $132.00
1 -Rolloff(20 Yd) On Call Service (S2)
Date Description Reference Quantity Unit Price Amount
° 10/17 Basic Service Laura 1.0000 $275.00 $275.00
Receipt Number 34273
$539.00
Current Invoice Charges $407.00
Due By: 11/20/12
Customer Service (317)917-7300
°lYdllL�lJlAS ° `.UU..
Effective 4/16/2012:SERVICE INTERRUPTION
POLICY CHANGE All accounts with a balance over
60 days will experience a service interruption unless
prior arrangements are made.
CURRENT 18 001104",V 0,�,» � ,I 0,t7AYS
407.00 132.00 0.00 0.00
To pay on-line or sign up for Past Due Balance $132.00
convenient auto pay, go to: D A • Visit our website,www.disposal.com to make your payment electronically
WWW.disposal.com or to sign up for our convenient automatic payment plan.
• Please.see reverse side for terms and conditions
CITY OF CARMEL BROOKSHIRE GOLF 3-0761-0035460 Page 2 of 2
Check Processing: In accordance with Federal Reserve Board guidelines, when you provide a check as payment, you
authorize us to use information from your check to make a one-time electronic fund transfer from your account or to
process the payment as a check transaction. When we use information from your check to make an electronic fund
transfer, funds may be withdrawn from your account as soon as the same day we receive your payment and you will not
receive your check back from your financial institution. For further information visit: www.electronicpayments.org and click
on the Check Conversion tab.
If service is canceled during a billing cycle, the customer will remain responsible for all charges, fees and taxes through the
end of the billing cycle. There will be no proration of billing, and the customer will not be entitled to a refund for the period
between the notice of termination and the end of the current billing cycle. This provision will not apply if it is contrary to a
current franchise agreement, municipal contract, or other written contract applicable to this account or is otherwise
prohibited by law.
The Company reserves the right to require that payment for services be made only by check, credit card or money order,
unless otherwise required by contract or applicable law.
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))
10/31/12 0761-001385586 Trash Collection $132.00
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
Republic Services #761
IN SUM OF $
P. O. Box 9001099
Louisville, KY 40290-1099
$132.00
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1207 1 0761-0013855861 43-501.01 1 $132.00 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
Tuesday, November 13, 2012
WY//
Director, Brooksh Golf Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund