219365 04/24/2013 CITY OF CARMEL, INDIANA VENDOR 359984 Page 1 of 1
r c ` ONE CIVIC SQUARE INDIANA GOLF CAR
,{ 3< CARMEL, INDIANA 46032 1770 B EAST 265TH STREET CHECK AMOUNT: E37.10
•�, _;' ARCADIA IN 46030 CHECK NUMBER: 219365
CHECK DATE: 412 412 01 3
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4350000 2384 37 . 10 EQUIPMENT REPAIRS & M
Indiana Golf Car, Inc. Invoice
1770 B E 266th
Arcadia, IN 46030 Date "2394
4/16/2013
Bill To Ship To
BROOKSHIRE G.C. BROOKSHIRE G.C.
12120 BROOKSHIRE PKWY. 12120 BROOKS141RE PKWY.
CARMEL,IN 46033 CARMEL,IN 46033
P.O. Number Terms Rep Ship Via F.O.B. Project
RUSSELL. Net 30 4/16/2013
Quantity Item Code Description Price Each Amount
1 1017188 BELT,CA DRIVE 25.70 25.70
1 101916701 BELT,STARTER-GENERATOR 11.40 11.40
I
Total $37.10
Prescri bed 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))
04/16/13 2384 Repair Parts $37.10
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
Indiana Golf Car, Inc.
IN SUM OF $
1770 B E 266th
Arcadia, IN 46030
$37 10
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1207 I 2384 I 43-500.00 I $37.10 1 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
Director, Brook 're Golf Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund