221483 07/02/2013 CITY OF CARMEL, INDIANA VENDOR: 361032 Page 1 of 1
r ONE CIVIC SQUARE DYNA SYSTEMS CHECK AMOUNT: $280.32
CARMEL, INDIANA 46032 P 0 BOX 971342
DALLAS TX 75397-1342 CHECK NUMBER: 221483
CHECK DATE: 7/2/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4350000 20689944 280 . 32 EQUIPMENT REPAIRS & M
Dyna Systems SHIP TO Invoice
P.O. Box 655326 FBROOKSHIRE GOLF CLUB
Dallas, TX 75265-5326
1800) 336-0450 RUSSEL PICKETT 1 of 1
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12120 BROOKSHIRE PKWY
A Partsmaster Company, k CARMEL, IN 46033
Division of NCH Corporation
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BILL TO REMIT TO: PO BOX 971342 `ON
BROOKSHIRE GOLF CLUB DALLAS TX 75397-1342 'cd�e Numge��
BOB HIGGINS "Distribution services include shipping and handling
12120 BROOKSHIRE PKWY charges.Returned merchandise not accepted without
CARMEL IN 46033 return goods authorization.All return claims for errors
or adjustments of any kind must be made within 15
days after receipt of goods.
INVOICE # INVOICE DATE CUSTOMER # CUSTOMER P/O DUE DATE
20689944 06/18/13 DY305524 RUSSEL 07/18/13
ORDER # SHIP DATE SALES REP RELEASE # SHIP VIA
20614275-1 06/18/13 D202 D202!7387 FEDEX GROUND
FOR REORDERS CALL 1-800-336-0450 FAX 1-972-721-6870
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PARt:NO;>: ;Q.ESC RIfi?k1G1NISIZE::::>::::>::>::s::: :>::::>:::>:::<:<::_»:::<::<.;:..:. »:>:::::::>::::>::::>::::>::::>::::>::::>:::::>:::PKG:: :<:;: '::;:,: E�CY SHP::i::::'afh!(T f?RECE::>_:EX7.A Oi]N.,:..
......... QTY <:.
DY00722147 CAP SCREW DYNAMARK EA 20 30 30.55
DY03021300 WASHER FLAT USS DOMESTIC EA 0 100 11.40
DY03481300 WASHER SPLIT LOCK EA 0 100 5.20
DY03021700 WASHER FLAT USS DOMESTIC EA 0 100 20.40
DY03022900 WASHER FLAT USS DOMESTIC EA 0 50 28.30
DY20366605 CRIMP& SHRINK BUTT CONNE EA 0 50 71.08
DY50230600 WASHER METRIC FLAT EA 0 100 4.20
DY50120500 NUT METRIC HEX EA 0 100 3.40
DY50120600 NUT METRIC HEX EA 0 100 5.40
DY50010820 CAP SCREW HX HD GR 8.8 EA 0 50 21.95
DY50231000 WASHER METRIC FLAT EA 0 100 12.80
DY50341000 WASHER MET LOCK EA 0 100 22.70
DY02212100 NUT NYLON INSERT LOCK EA 0 50 19.91
SUB-TOTAL DISCOUNT MIN ORDER CHG SALES TAX —SHIPPING TOTAL
257 29 0.00 23.02 AMOUNT 280.31
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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))
06/18/13 20689944 Repair Parts $280.32
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
Dyna Systems
IN SUM OF $
P.O. Box 971342
Dallas, TX 75397-1342
$280.32
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1207 I 20689944 I 43-500.00 I $280.32 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
Friday, June 28, 2013
Director, Brooks Golf Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund