217780 02/26/2013 CITY OF CARMEL, INDIANA VENDOR: 358941 Page 1 of 1
ONE CIVIC SQUARE PETTY CASH-BROOKSHIRE GOLF COTgg
` CARMEL, INDIANA 46032 C/O PAM LISTER CHECK AMOUNT: $16.67
CHECK NUMBER: 217780
CHECK DATE: 2/2612013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4350100 16 . 67 BUILDING REPAIRS & MA
W MALTA #206
4755 E. 126TH ST.
CARMEL, IN 46033
(317)844-4372
3678 ENERGIZER 9 UCLI 7.49 T
* TAX .52 BAL 8.01
CASH 10.01
CHANGE 2.00
TOTAL NUMBER OF ITEMS SOLD = 1
2/14/13 11 :23 AM 0206 02 0013 113
YOUR CASHIER WAS MONA
THANK YOU FOR SHOPPING
O ' MALIA
CHECK US OUT: http://www.omalias.com
LOWE'S HOME CIFNIERI;, INC.
14598 t0wl-'i WAY
CARMEL, IN 4603'.. 5bb-8124
— SiN[-E --
SALES-: FSTLANE4 13 IRANSO: ?6454360 02-21-13
178774 14"x7/64" RED C0P CHOP SA 9.18
S'UBIOl';L: 9.18
[AX: 0.64
INVOICE 07903 1 4k: 9.82
9.82
JUI(XXXXXhXXXX)O AII,'JIJNI:9.87. AUTHUD:
SWIPED REF10:4543111t2507 112/21/13 08:46:11
I-RACE:010169017
PURCHA'.')F. CASH BACK TOTAL DEBI I
9.32 0.jo 9.82
STORE: 1525 iERMI[NAL: 07 0112/21/13 08:46:13
0 OF I TE'MS PIJF.CIIASED: 1
EXCLUDES FEES, SERVICES AND SPECIAL ORDER ITEMS
(HANK YOU FOR SH(JPPIHG LOWE'S.
SEE REVERSE SIDE FOR R[I'URN POLICY.
STORE MANAGER: MAIT KREBS
WE)HAVE THE LOWESI Pl'' WILL.I C)' GUARANTEED!
IF YOU FIND A LOWER PRI(E, WE L BEAT IT BY IOZ.
SEE STORE FOR DEIAILS.
YOUR OPIGON') COUNT!
REGISTER fO WIN A $`,0110 LfIWE'S GIFf CARD!
iREGISIRESE PARA GANAR U1,A (AR)ETA DE REGALO LOWE'S!
REGISTER 0
il' BY CUMPLEIING � GUEST SATISFACTION SURVEY
WITHIN ONE WEEK AI: www.lowes.com/survey
Y 0 U R 1 0 P. 3790 1525 052
NO PURCHASE NECES`ARY 11) ENTER OR WIN.
• VOID WHERE PROHIBITED. M!Sl BE 18 OR OLDER TO ENTER.
• OFFICIAL RULES & WINNER` Al: ww.lowes.com/survey
4,**4**41 4 N4•
STORE: 1525 fl-RMTNAL: 07 0.2!/21/13 08:46:13
VOUCHER NO. WARRANT NO.
ALLOWED 20
Petty Cash
IN SUM OF $
$16.67
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1207 I O'Malia I 43-501.00 I $7.49 1 hereby certify that the attached invoice(s), or
1207 I Lowe's I 43-501.00 I $9.18 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
Thursday, February 21, 2013
Director, Brookshir olf 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))
02/14/13 O'Malia Batteries $7.49
02/21/13 Lowe's Building Materials $9.18
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