218379 03/25/2013 - CITY OF CARMEL, INDIANA VENDOR: 00350801 Page 1 of 1
ONE CIVIC SQUARE AUTOMATIC IRRIGATION SUPPLY CO
? ) CHECK AMOUNT: $3,019.00
CARMEL, INDIANA 46032 116 SHAVJDOVVLAVJN DRIVE
FISHERS IN 46038-2431 CHECK NUMBER: 218379
CHECK DATE: 3/25/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4350900 20021 3000414-IN 3 , 019 . 00 SERVICE PLAN
f1VOICe Page: 1
116 Shadowlawn Drive Invoice Number: 3000414-IN
Fishers, IN 46038-2431 Invoice Date: 3/11/2013
b (317)842-3123
(800)842-3911
AUTOMATIC IRRIGATION Fax(317)845-0977 Order Number: 3000414
S U P P L Y C 0 M P A N Y Order Date 3/11/2013
Salesperson: GOLF
PLEASE REMIT TO OUR FISHERS ADDRESS Customer Number: 09-0002055
BROOKSHIRE/CITY OF CARMEL BROOKSHIRE GOLF CLUB
12120 BROOKSHIRE PKWY 12120 BROOKSHIRE PARKWAY
CARMEL, IN 46032 CARMEL, IN 46032
Confirm To:
BOB HIGGINS
P.O.Customer Ship VIA F.O.B.
20021 30 DAYS NET
• . Ship :• Item Number
/SPLAN GSP SERVICE PLAN ANNUAL 3,019.00
WITH COMPUTER
Net Invoice: 3,019.00
Less Discount: 0.00
Freight: 0.00
Sales Tax: 0.00
You May Deduct $0.00 If Paid by 3/11/2013 Invoice Total: 3,019.00
f� INDIANA RETAIL TAX EXEMPT PAGE
City o C°�anal CERTIFICATE NO.003120155 002 0 Jl ��1//CSJ.i 11 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT �C.".,-1/
35-60000972 �YX
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,A/P
CARMEL, INDIANA 46032-2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL- 1997
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. / DESCRIPTION
9' ,)
VENDOR + _l�Gce SHIP
TO
CONFIRMATION BLANKET' CONTRACT PAYMENT TERMS FREIGHT
x
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Send Invoice To:
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
A,2 7�'�o (.C� PAYMENT
• A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATION SHIP REPAID. SUFFICIENT TO PAY FOR THE ABOVE ORDER.
•
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS.
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE f I�t q i f"C, ��1!A 'a!: 'f+ev l
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT T'"'HyyERRjETO.
, (
.I r) CLERK-TREASURER
f> V
DOCUMENT CONTROL NO. A. . . COPY-SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO. WARRANT NO`____
'
ALLOWED 20__—
|N THE SUM OF$ '
ON ACCOUNT{}F APPROPRIATION FOR `
`
. `
Boa �ombe ' ~INVOICE NO, ACCT#ITITLE AMOUNT�u� � .
DEPT# | hereby certify that the attached invoice(s), or
� bill(s) is (are) true and ooneotand that the
— materials or services itemized thereon for . '
which charge ie made were ordered and
received except .
!
'
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund