220747 06/04/2013 CITY OF CARMEL, INDIANA VENDOR: 358941 Page 1 of 1
ONE CIVIC SQUARE PETTY CASH-BROOKSHIRE GOLF CO�g CHE
CARMEL, INDIANA 46032 C/O PAM LISTER CK AMOUNT: $278.91
CHECK NUMBER: 220747
4't-ro_ip
CHECK DATE: 6/4/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4239040 136 . 92 FOOD & BEVERAGES
1207 4350000 141 . 99 EQUIPMENT REPAIRS & M
VOUCHER NO. WARRANT NO.
ALLOWED 20
Petty Cash
IN SUM OF $
$136.92
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1207 Sams 42-390.40 $8.68 1 hereby certify that the attached invoice(s), or
1207 Omalia 42-390.40 $6.00 bill(s) is (are)true and correct and that the
1207 Entenmanns 42-390.40 $3.00
materials or services itemized thereon for
1207 Sams 42-390.40 $3.70
which charge is made were ordered and
1207 Meijer 42-390.40 $4.57
1207 Sams 42-390.40 $12.37 received except
1207 I Meijer I 42-390.401 $21.89
1207 GFS 42-390.40 $14.97
1207 Entenmanns 42-390.40 $7.50
1207 I O'Malia I 42-390.40 I $19.98 Monday, June 03, 2013
1207 I Costco I 42-390.401 $34.26
Director, Brookshire olf 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))
05/16/13 Sams Food $8.68
05/16/13 Omalia Food $6.00
05/24/13 Entenmanns Bread $3.00
05/24/13 Sams Food $3.70
05/24/13 Meijer Food $4.57
05/26/13 Sams Food $12.37
05/27/13 Meijer Food $21.89
05/27/13 GFS Food $14.97
05/29/13 Entenmanns Bread $7.50
05/30/13 O'Malia Food $19.98
05/31/13 I Costco I Food I $34.26
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
Allied Auto Hail Repair
Corporate Headquarters ! (317) 397-3444 Northside Location
9460 E.Washington Street �} Efax: 1-888-346-9264 11771 N.Technology Ln.,Ste. 100
Indianapolis,IN 46229 Email:myhailrepair @gmail.com Fishers,IN 46038
Name Dal
Address Insurance
Cry x S p Code GJ� Claim Number
Ham
' .Time Appt.Dade Estimator
Work# Referred By ���' Technician
VehQ// E-mail '.Vin#
o, ��✓ c PANG. DESCRIPTION AMOUM
1. HOOD S
1 ROOF 4 3<4z� � °J $
FRONT 3. TRUNK/TAILGATE d, $ J v "�-
4. L RAIL
S. L 114
1 6 Lit DOOR S
7 8 7. lF DOOR $
8. LF FENDER
6 9
9. RF FENDER 3
10. RF DOOR s
2 11. RR DOOR $
12. R RAIL 3
5 10 13. R 1/4 $
14. RN HEAMOR 4 4 $ f�^
/ INVOICE w,/ S
4 11 suBLET S
3 PARTS/AWL REPAIRS A S
TAX
REM LABOR s
CUSTOMER TOTAL
Comment/Supplement Secti®n CUSTOMEWS
IMCLU®IS TMM 1. You may not be charged more than the written
estimate without your consent.
2. Repairs not originally authorized by you may not
be charged to you without consent.
Allied Auto Hail Repair(AAHR)is not responsible for the security or condition of any personal property left in vehicle.
I authorize the repairs listed above using AAHR paintless techniques. I authorize AAHR technicians to operate my vehicle for transfer
and delivery.An express"mechanics lien"is hereby granted. i agree to pay in full listed"CUSTOMER TOTAL"prior to release of vehicle
and lien.This agreement may not be ame6c ed in writing. I agree to pay any reasonable a ey's f an ou co is incurred in the
collection of this account,or the perfection of any lien.
41- 81 t
i er's Signature
I have inspected the repairs made to this vehicle and found them satisfactory. sig re_._}ndi ace ni product and
I assume responsibility for payment for the repairs made.
Customer's Signature
VOUCHER NO. WARRANT NO.
ALLOWED 20
Petty Cash
IN SUM OF $
$129.00
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. I ACCT#/TITLE AMOUNT Board Members
1207 I Allied I 43-500.00 I $129.00 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
Thursday, May 30, 2013
&rector, Brookshir olf 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))
05/28/13 Allied Repair Car Damage $129.00
1 hereby certify that the attached invoice(s), or bill(s), is(are)true and correct and I have audited same in accordance
with IC 5-11-10-1.6
, 20
Clerk-Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
Petty Cash
IN SUM OF$
$12.99
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1207 I Tractor Supply I 43-500.00 I $12.99 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
Tuesday, May 28, 2013
Director, Brooks A Golf 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))
05/23/13 Tractor Supply Repair Parts $12.99
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