219209 04/24/2013 CITY OF CARMEL, INDIANA VENDOR: 359457 Page 1 of 1
` ONE CIVIC SQUARE AMERICAN DRY GOODS CHECK AMOUNT: $98.77
?a CARMEL, INDIANA 46032 PO BOX 790051
ST LOUIS MO 63179-0051 CHECK NUMBER: 219209
CHECK DATE: 4/2412013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4356006 105732 98 . 77 GOLF SOFTGOODS
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M�'� U O1 05732 1
P.O. BOX 790051 -INVOICE DA
St. Louis, MO. 63179-0051
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TELEPHONE: �---'-------- �
PO BOX79OO 1
800f822'2708 REMIT TO:
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=��� ST LOUIS, MO 63179-0051
FAX: 800-822-2709 � '
/ AS| # 35498
CITY OF CARMEL �S CITY OF CARMEL
DBA/8ROOMSHIRE G. C. ` " DBA/8ROOKSHIR�� Q. C.
D ATTN. BRIAN 8ALLARD I": ATTN: BRIAN BALLARD
� � [r 12120 8ROOKSHIRE PKWY �
CARME-L IN 46033 , '0' CARMEL IN 46033
ORDER
| \ ACCOUNT �� o^�» YOUR PURCHASE
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RDERnA[E '� �N SHIP VIA vvv�vw TERMS NUMBER �i NUMBER O ORDER NUMBER
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87088'110/23/ 12 ( 4675O �4O ORS --____- ^UPS <�ROUND PREPAIDl� _- NET. 3O-
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ITEM NUMBER DESCRIPTION COLOR UNIT PRICE EXTENDED PRICE
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12- .IADGPPV1 IAGST, LADIES DECR VISOR ASST. 7. 50 90. OO
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WEIGHT 3 LBa � SALE AMOUNT 90. 00
1-CARTONS _ _ FREIGHT 8. 77
1O5732 PAY THIS
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� AMOUNT 98. 77
muoLmwa MUST as MADE WITHIN m DAYS opnsosIProponooa NO RETURNS 'THE GOODS COVERED/w THIS INVOICE WERE PRODUCED IN
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WITHOUT WRITTEN CONSENT.ALL CORRESPONDENCE TO BE MADE DIRECTLY TO THE FAIR LABOR STANDARDS ACT OF 1938." CUSTOMER COPY
AMERICAN DRY GOODS,p.0 BOX s39ml PARAMOUNT DRIVE,BOURBON,Moow41
1
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))
03/29/13 105732 Soft Goods $98.77
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
120
Clerk-Treasurer
■
VOUCHER NO. WARRANT NO.
American Dry Goods ALLOWED 20
IN SUM OF $
P.O. Box 790051
St. Louis, MO 63179-0051
$98.77
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
T
1207 I 105732 I 43-560.06 I $98.77 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
Monday, April 22, 2013
hz_✓
Director, Brooks i e Golf Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund