HomeMy WebLinkAbout215666 12/18/2012 - CITY OF CARMEL, INDIANA VENDOR: 140100 Page 1 of 1
ONE CIVIC SQUARE IBS OF INDIANAPOLIS
CARMEL, INDIANA 46032 6848 E.21ST STREET CHECK AMOUNT: $13,999.00
INDIANAPOLIS IN 46219 CHECK NUMBER: 215666
CHECK DATE: 12/18/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4350000 20026 103456 13 , 999 . 00 GOLF CART BATTERIES
IBS OF INDIANAPOLIS //VTERST.4�TE Page: 1
6848E 21st St. B�]ryEa®mss
Indianapolis IN 46219
(317) 322-1818
Invoice Nbr :103456
DEALER NBR. 3403 Location of Sale :WO I
BROOKSHIRE GOLF COURSE Sales Person Name :DENNIS MCDANIEL
12120 BROOKSHIRE PKWY Sales Person Nbr :DM
CARMEL IN 46033-3314 PO Number :20026
Date :1211312012
(317)846-7431 Time :11:21:07 AM
Payment Type: CHARGEACCOUNT 11 1
Type Qty PartNumber/Desc Age Rate Price Amount
Sale too 12VGCUTL 139.99 11999.00
Sales Total
13,999.00
Cores Received 100 HVCORE
Sub Total 13,999.00
Sub Total 13.999.00
Invoice Total 13,999.00
Invoice Payment Amount 0.00
Net Invoice $13,999.00
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Dealer Aging-Current Balance Total 13,999.00
0 to 30 days 13,999.00
31 to 60 days M
61 to 90 days .00
91 days or more 00
Invoices
I03456 11999.00
PRINT NAME HERE
SIGNATURE
c4 INDIANA RETAIL TAX EXEMPT PAGE
uy o Carmel CERTIFICATE NO.003120155 002 0 JL PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT
35-60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,A/P
CARMEL, INDIANA 46032-2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL- 1997
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
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VENDOR d t.
! � } SHIP TO ,�f /�..�M 1!jG-r•. . �N Grp "
CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT
QUANTITY UNIT OF MEASURE ,DESCRIPTION% UNIT PRICE EXTENSION
Send Invoice To: a "'
^ ✓ c Eye; -r,,t•r
PLEASE INVOICE IN DUPLICATE ! �>
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
_ i �i`a ' PAYMENT
• A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS'THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
a THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
•SHIP REPAID. d
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED.
ORDERED BY
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL .\
SHIPPING LABELS.
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
2 V o 6 CLERK-TREASURER
DOCUMENT CONTROL NO. COPY-SIGN AND REfR N TO'CLERK'S OFFICE
VOUCHER NO. WARRANT NO.._..._._..___
ALLOWED 20
IN THE SUM OF$
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO#or INVOICE NO. ACCT#/TITLE AMOUNT
DEPT.# 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.._...___..........................................................
20
............................................................................................................................................... ...._
Signature
....................................................................................... .................................................................
Title
Cost distribution ledger classification if
claim paid rnotor vehicle highway fund
VOUCHER NO. WARRANT NO.
ALLOWED 20
IBS of Indianapolis
IN SUM OF $
6848 E. 21st Street
Indianapolis, IN 46219
$13,999.00
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
.I&M— I 103456 I 43-500.00 I $13,999.00 1 hereby certify that the attached invoice(s), or
02� 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, December 17, 2012
T��' X 4 W,,
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))
12/13/12 I 103456 I Batteries I $13,999.00
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