215338 12/11/2012 CITY OF CARMEL, INDIANA VENDOR: 359984 Page 1 of 1
ONE CIVIC SQUARE INDIANA GOLF CAR
CHECK AMOUNT: $80.00
i,�lro CARMEL, INDIANA 46032 1770 B EAST 266TH STREET
ARCADIA IN 46030 CHECK NUMBER: 215338
CHECK DATE: 12/11/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 4617 80 . 00 TRANSPORTATION EXPENS
Indiana Golf Car, Inc. Invoice
1770 B E 266th
Date Invoice#
Arcadia, IN 46030
11/30/2012 4617
Bill To Ship To
CARMEL UTILITIES CARMEL UTILITIES
9609 HAZEL DELL PARKWAY 9609 HAZEL DELL PARKWAY
INDPLS,IN 46280 INDPLS,IN 46280
P.O. Number Terms Rep Ship Via F.O.B. Project
JEFF COOPER Net 30 11/30/2012
Quantity Item Code Description Price Each Amount
1 MISC PARTS USED CANOPY TOP 40.00 40.00T
IT
-.1..MISC PARTS
40.00
State Sales Tax 7.00% �.6
Total $85:60'.
VOUCHER # 126259 WARRANT # ALLOWED
359984 IN SUM OF $
Indiana Golf Car, Inc.
1770 B East 266th Street
Arcadia, IN 46030
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
4617 01-7502-06 $80.00
Voucher Total $80.00
Cost distribution ledger classification if
claim paid under 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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
359984
Indiana Golf Car, Inc. Purchase Order No.
1770 B East 266th Street Terms
Arcadia, IN 46030 Due Date 12/4/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/4/2012 4617 $80.00
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
Date Officer