215190 12/04/2012 CITY OF CARMEL, INDIANA VENDOR: 00352369 Page 1 of 1
0 ` ONE CIVIC SQUARE SUNBELT RENTALS
CARMEL, INDIANA 46032 Po Box 409211 CHECK AMOUNT: $849.52
ATLANTA GA 30384-9211
CHECK NUMBER: 215190
CHECK DATE: 12/4/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4353099 37457917-001 849 . 52 OTHER RENTAL & LEASES
INVOICE
SEND ALL PAYMENTS TO:
SUNBELT RENTALS,INC. • • 37457917-001
PO BOX 409211
ATLANTA,GA 30384-9211
72326
0
RENTALS
11/15/12
PAGE 1 of 1
INVOICE TO RECEIVED BY CONTRACT NO.
o toz-610-753 HIGGINS, BOB 37457917
BROOKSHIRE GOLF CLUB PURCHASE ORDER NO.
12120 BROOKSHIRE PKWY
CARMEL IN 46033-3314 N/R
(�InIiIInllnnillnilln�Ilnillnnllilnlnlilllniiiilll JOB NO.
1 - BROOKSHIRE GOLF
JOB ADDRESS BRANCH
BROOKSHIRE GOLF CLUB INDIANAPOLIS P & P PC387
12120 BROOKSHIRE PARKWAY 11220 AL_LISONVILLE RD
CARiV1EL, IN 46 033 FISHERS, IN 46038-1839
317-501-2146 317-572-1180
QTY EQUIPMENT# Min Day Week 4 Week Amount
1 915CFM 150PSI IQ DIESEL AIR COMPRESSOR 485.00 485.00 1185.00 3805.00 485.00
473831 Make: DOOSAN Model: HP915WCU Ser#: 442344UFWE16
HR OUT: 329.900 HR IN: 339.800 TOTAL: 9.900
Billed from 11/12/12 thru 11/13/12
RATE OF A 750CFM
1 2"X 50'AIR COMPRESSOR HOSE 51.00 51.00 125.00 340.00 51.00
1 BULL HOSE SPUD CONNECTOR N/C
2" BOSS X 1" FPT
2 AIR HOSE WHIP CHECK N/C
SALES ITEMS:
Qty Item number Unit Price
1 DLPKSRCHG EA 21.000 21.00
TRANSPORTATION SURCHARGE
1 ENVIRONMENTAL EA 12.120 12.12
ENVIRONMENTAL
1 RENTAL PROTECTION PLAN EA 80.40
DELIVERY CHARGE 100.00
PICKUP CHARGE 100.00
QTY EQUIPMENT# Amount
FINAL BILL: 11/12/12 09:00 AM THRU 11/13/12 03:35 PM.
EgWpment. Ser* ce. Guaranteed. 849.52
REMIT TO: NET DUE UPON RECEIPT �um
SUNBELT RENTALS, INC. Invoices not paid within 30 days may be subject • • 849.52
PO BOX 409211 to a l-'/2%per month charge.
ATLANTA, GA 30384-9211
RENTAL RETURN
VOUCHER NO. WARRANT NO.
ALLOWED 20
Sunbelt Rentals
IN SUM OF $
P.O. Box 409211
Atlanta, GA 30384-9211
$849.52
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1207 I 37457917-001 I 43-530.99 I $849.52 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 27, 2012
;Z�� A 6A /
Director, Brookshi 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))
11/15/12 37457917-001 Rental Equipment $849.52
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
120
Clerk-Treasurer