217312 02/13/2013 CITY OF CARMEL, INDIANA VENDOR: 358941 Page 1 of 1
ONE CIVIC SQUARE PETTY CASH-BROOKSHIRE GOLF CO�g
` CARMEL, INDIANA 46032 C/O PAM LISTER CHECK AMOUNT: $201.90
CHECK NUMBER: 217312
CHECK DATE: 2/13/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 41 . 96 FOOD & BEVERAGES
1207 4350100 159 . 94 BUILDING REPAIRS & MA
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))
02/09/13 I Sam's I Banquet Cookies I $41.96
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
Petty Cash
IN SUM OF $
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1207 I Sam's I 42-390.40 I $41.96 1 hereby certify that the attached invoice(s), or
52 �UV1 �J 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, February 11, 2013
Director, BrookshA Golf Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund