219338 04/24/2013 CITY OF CARMEL, INDIANA VENDOR: 366165 Page 1 of 1
` ONE CIVIC SQUARE HJ GLOVE
fr CARMEL, INDIANA 46032 PO BOX 3031 CHECK AMOUNT: $399.73
THOUSAND OAKS CA 91359 CHECK NUMBER: 219338
CHECK DATE: 4124/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4356006 28474 399 . 73 GOLF SOFTGOODS
HJ GLOVE DWOUCE
Remit to Invoice Number 28474
P O. Box 3037 Invoice Date Apr 8,2013
Thousand Oaks, CA 91359 SO Number CM16698
Tel 818-889-2223 Page 1
Fax 618-889-9922 Duplicate
E-Mail. info @hjgiove.com
Web: www higlove-com
Bill To: Ship To:
City of Carmel City of Carmel
Brookshire Golf Club Brookshire Golf Club
12120 Brookshire Parkway 12120 Brookshire Parkway
Carmel, IN 46033 Carmel, IN 46033
Cus tome rID Customer.PO PaymentTerms
460BR2120 Net 30 Days
Sales Rep Shipping Method Ship Date Due Date
Richardson Golf Sales, Inc. UPS GROUND 4/8/13 5/8/13
Quantity Item Description jBackorder Ctyj Unit Price Amount
Shipped on.04/08/2013
Tracking#. 1Z79777E0371830739
Service Ground
Total Weight 11 0
Number of Packages 1
Billing Option. Prepaid
End Shipment(s)
8 S-777-MLH-S Function 420 3360
15 S-777-MLH-M Function 420 6300
15 S-777-MLH-ML Function 420 63.00
15 S-777-MLH-L Function 420 63.00
8 S-777-MLH-XL Function 4.20 3360
7 S-777-CLH-M Function 420 29.40
7 S-777-CLH-ML Function 420 29.40
7 S-777-CLH-L Function 420 29.40
1 S-777-MRH-S Function 420 420
2 S-777-MRH-M Function 4.20 840
2 S-777-MRH-ML Function 420 8.40
2 S-777-MRH-L Function 420 840
1 S-777-MRH-XL Function 420 4.20
1 5/6 Your price reflects the"Buy 5/Ship 6" boxes program.
90 Total quantity
Subtotal 378.00
Freight 21 73
Total Invoice Amount 399 73
Payment/Credit Applied
Check/Credit Memo No: TOTAL 399.73
Prescribed by Slate 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))
04/08/13 28474 Gloves $399.73
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
VOUCHER NO. WARRANT NO. _
ALLOWED 20
HJ Glove IN SUM OF $
P.O. Box 3037
Thousand Oaks, CA 91359
$39973
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO ACCT#!TITLE AMOUNT Board Members
1207 I 25474 I 43-56006 I $399.73 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 15, 2013
Director, Brookshl e Golf Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund