219450 04/24/2013 - CITY OF CARMEL, INDIANA VENDOR: 358941 Page 1 of 1
ONE CIVIC SQUARE PETTY CASH-BROOKSHIRE GOLF COBS
CARMEL, INDIANA 46032 CHECK AMOUNT: $19450
CIO PAM LISTER
CHECK NUMBER: 219450
CHECK DATE: 4/24/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 32 . 23 FOOD & BEVERAGES
1207 4342100 8 . 02 POSTAGE
1207 4350100 138 .41 BUILDING REPAIRS & MA
)(R Kirby Risk
WC 51
KIRBY RISK REDISTRIBUTION CENTER900 S 10 6 8 3 7 8 08 . 001
5501 W 52ND ST
INDIANAPOLIS IN 46254-1637 Page 1 of 1
317-687-0015 Fax 317-298-2888
SOLD TO: SHIP TO:
CASH BRANCH 51 CASH BRANCH 51
11110 ALLISONVILLE RD 11110 ALLISONVILLE RD
FISHERS, IN 46038-1837 FISHERS, IN 46038-1837
317-598-6170 fax 317-598-6171 317-598-6170 fax 317-598-6171
** C.O.D. ** C .O.D. ** C.O.D. **
U TOME N
C . &. UMBE&.:. ... -:>.::.:>:>:IUSTOMER:ORDER NUMBS
:,:... ff c: ::;..;:. >:;":>::::»:. RELE.A.SE NUMBER.. :_::>:>:>:.::<>:. ,_ .:;<:;:. SBPPi:IER.CflUE.::
89333 BROOKSHIRE GG
WRITER flRDER£U:BY " 511[ES OREtER #..:: 5ffIP BRAi9CM SHTP:3�ATE.
MIKE E WILSON KEN 5106837808 . 001 900 04/09/13
dot .9 »;SHIP QTY. i►M<: `:?';:__: i. flfSCRTPLION -:.. a. . P 9 '::!
.::. I em r ce Unit:;.'";; El t FrSSe"
3 3 ea T&B 40HPS 2947 . 44 100ea 88 . 42
SPLIT-BOLT PLTED W/SPACER
Carton: BOX-841893 Loc : 51 FISHER K
f312a137:27:41AM S1asa3780E.001
KEN
Paid On 04/09/13-Cash $88.42 Subtata.l..'' 88. 42
S&H .CHGS: 0.00
Sales Tax 0.00
R:a.:, tints:::::::;:;::: -88. 42
m6ta1...::_
X nozin:t: bue 0. 00
ALL ITEMS BEING RETURNED COULD BE SUBJECT TO A RESTOCKING CHARGE.
CUSTOMER-PLEASE NOTE: ALL CLAIMS FOR SHORTAGE OR DAMAGE MUST BE MADE WITHIN 5 DAYS AND
MUST REFERENCE THE SALES ORDER NUMBER. NO MATERIAL MAY BE RETURNED WITHOUT PRIOR APPROVAL.
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))
04/09/13 WC51 Bolts $88.42
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
Petty Cash
IN SUM OF $
$88.42
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1207 I WC51 I 43-501.00 I $88.42 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
Tuesday, April 09, 2013
J
Director, Brookshire dolf 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))
04/09/13 Omalia Food $10.50
04/13/13 Omalia Food $10.69
04/14/13 Omalia Food $8.75
04/17/13 Kroger Food $2.29
04/19/13 621001956 Shipping $8.02
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
Petty Cash
IN SUM OF $
$40.25
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1207 Omalia 4Z, y6-q-b $10.50 1 hereby certify that the attached invoice(s), or
1207 Omalia $10.69
bill(s) is (are)true and correct and that the
1207 Omalia 4-1'3 y6 1/d $8.75
materials or services itemized thereon for
1207 Kroger 4V35,e).' $2.29
which charge is made were ordered and
1207 621001956 4421.00 $8.02
received except
Monday, April 22, 2013
Director, Brook e Golf Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Use Your
ltt� 2.%
BIG CARD REBA JY
MENARDS -- KOKOMO
1715 EAST HAVENS 's-r .
KOKOMO I N.,, 46901
KEEP YOUR RECEIPT
RETURN POLICY VARIES BY PRODUCT 'TYPE
Unless noted below allowable' .retur'ns for
items on this receipt will be in the form
of an in store credit.voucher if the
return is done after 07/20/13 <�
. II VIII III IIII VIII I I I II ._.
Sale Transaction
1/2" ELECTRIC IMPACT KIT*
2419897 49.99 NT
TOTAL 49.99
TOTAL SALE 49.99
CASH 100.00
CHANGE 50.01-
TOTAL SAVINGS 19.99
TOTAL NUMBER OF ITEMS = 1
THANK YOU, YOUR CASHIER, KIERRA
6527 02 4540 04/21/13 05:48PM 3146
iceturnea merchandise max way purc=secI w
on rebate must have original rebate re
Without rebate receipt, the value of the r
Will be deducted from the return
Returns, price adjustments, or exchan es—wa
affect our rebate amount issued by
clearinghouse,.
Sale price adjustments Neill be�llbwed during the
sale of an item when this.item was purchased up
to 14 mays rior to the sal®;'an-Jn-story credit will
be issued'for this liikande: However sale price
adjustments are not allowed on en3 of season
discounts,-closeout items,or special promotions.
Stock mercha disc tliat is cut or altered may be
subject'to.n restocking fddr.;
Exceaitionns"6oace�_ np yours Return
rr u gape°
Return Policy vaxaes;bg,prodidct,type.These
exceptionsfare denoted on the front ofthn
eeester'receipt.
Returns with 2 n°eceapt mthin 90 days of
-Purchase made'with 'cash or a debit card —a
cash refund will be issued,
-Purchase made with a clia ek—Refund will be
issued in the fbrm.of an,in-store credit,if receippt
is less than 14 days old.A cash refund will Be
issued if the Ghee-k is more thap;l4 days old and
you have no'bdtstpJing�che#.p V4*us.
o Purchase maitre ntli regLtit card*r ti credit will
be issued toflie account ' 1
-Purchase made with an in-store credit or gift
card—an�m store credit will be issued.
Returns Mth a reeei t dicer 00 days of
-In-s%re,credit will be issued'for the original
purchase price.
Mum without a receipts
-If in order, l ti-store cre&t will be issued—the
lowest price offered including discounts due to
coupons or rebates will be honored. We reserve.
the hSht'to REFUSE a refund without a receipt.,
Returns of-Holiday and Summer Seasonal Items.
will not be allowed without a receipt LA drivers
license or state I.D.will be requ_ir_ea.
1�I®II.1ID° N®LRt�"II v�I�Ie
Returns of SKed@R Orders:
Special order items may be refunded at N�ettards ,
sole discretion with a restocksin�fee.
General Gnaiolelln°taes ffor your Return or
V Any merchandise missm °the ork al QTTPC`
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))
04/21/13 Menards Impact Kit $49.99
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
Petty Cash
IN SUM OF $
$49.99
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1207 I Menards I 43-501.00 I $49.99 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 hire Golf Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund