216793 01/29/2013 CITY OF CARMEL, INDIANA VENDOR: 361429 Page 1 of 1
0 ONE CIVIC SQUARE M D A CHECK AMOUNT: $421.97
CARMEL, INDIANA 46032 PO BOX 3110
MONUMENT CO 80132 CHECK NUMBER: 216793
CHECK DATE: 1/29/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4356006 110327 421 . 97 GOLF SOFTGOODS
(MIDA) MAXX SUNGLASSES Invoice
MAXX SUNGLASSES Date Invoice #
PO BOX 3110
MONUMENT CO 80132
FBill To: Ship To:
Brookshire Golf Club IN Brookshire Golf Club IN
BRIAN BRIAN
12120 Brookshire Parkway 12120 Brookshire Parkway
Carmel, IN 46033 Carmel, IN 46033
Terms Due Rep Ship Date Via
Ate
UPS
Ne
Qty Description' Each Amount
3 GT Black 8.50 25.50
3 GT White 8.50 25.50
2 Python Blue 8.50 17.00
2 Python Carbon Fiber 8.50 17.00
2 Python White 8.50 17.00
1 Maxx Envy Black 8.50 8.50
1 Maxx Envy White W/Pearl Grey, Blue Rubber 8.50 8.50
1 Maxx Envy White W/Pearl Grey, Orange Rubber 8.50 8.50
1 Phantom Black 8.50 8.50
1 Phantom Blue 8.50 8.50
1 Phantom Lime Green 8.50 8.50
1 Phantom Orange 8.50 8.50
1 Phantom Red with White accents 8.50 8.50
1 Phantom White 8.50 8.50
1 Stealth Black 8.50 8.50
1 Stealth Blue 8.50 8.50
1 Stealth Lime Green 8.50 8.50
1 Stealth Orange 8.50 8.5 0
1 Stealth Red with White accents 8.50 8.50
1 Stealth White 8.50 8.50
2 Raven Black with White 8.50 17.00
3 Raven Silver with Black 8.50 25.50
3 Cinco Black 8.50 25.50
3 Cinco Blue 8.50 25.50
3 Cinco Red 8.50 25.50
3 Cinco White 8.50 25.50
1 UPS SHIPPING 13.97 13.97
Help us keep prices low! If these boxes are blank, please fill in and fax this page back to us.We will update your information!
Ie-mail: BBALLARD@CARMEL.IN.GOV Fax: 317-846-9980
PLEASE MAKE CHECKS PAYABLE TO "MOA" Total This Invoice
WE ACCEPT MASTER CARD, VISA AND DISCOVER Payments/Credits Applied to Invoice
87755O8118PHONE
� � Balance Due This Invoice
719.622.1153 FAX
'
Please inspect product carefully.All returns are mho made within Mb�o,f receipt and '(V»#)r with your sales representative.
Any problems should be
(MDA) MAXX SUNGLASSES Invoice
MAXX SUNGLASSES Date Invoice #
PO BOX 3110
MONUMENT CO 80132
Bill To: Ship To:
Brookshire Golf Club IN Brookshire Golf Club IN
BRIAN BRIAN
12120 Brookshire Parkway 12120 Brookshire Parkway
Carmel, IN 46033 Carmel, IN 46033
Terms Due Rep Ship Date Via
1 7 MD 1/10/2013
3 UPS
Oty Description Each Amount
Help uo keep prices low! If these boxes are blank, please fill in and fax this page back to us.We will update your information!
e-mail: BBALLARD@CARMEL.IN.GOV Fax: 317-846-9980
Total This Invoice $42197
PLEASE MAKE CHECKS PAYABLE TC) ^MOA"
VVE ACCEPT MASTER CARD, VISA AND DISCOVER Payments/Credits Applied toInvoice $0.00
87755O8118PHONE
� � Balance Due This Invoice $421.97
719.622.1153 FAX
�
( Total Due This Account) $421.97
Please inspect product carefully.All returns are mhc made within KW�uy/m��and a�ompaokdiyummmou�ohoh=""mhm�A�.
Any problems sh( c o r with your sales representative.
VOUCHER NO. WARRANT NO.
ALLOWED 20
M DA
IN SUM OF $
P.O. Box 3110
Monument, CO 80132
$421.97
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. I ACCT#/TITLE AMOUNT Board Members
1207 I 110327 I 43-560.06 I $421.97 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, January 22, 2013
Director, Bro 4 hire 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))
01/10/13 I 110327 I Sunglasses I $421.97
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