221951 07/17/2013 CITY OF CARMEL, INDIANA VENDOR: 361032 Page 1 of 1
` ONE CIVIC SQUARE DYNA SYSTEMS CHECK AMOUNT: $20.37
CARMEL, INDIANA 46032 P O BOX 971342
4 oN,�o DALLAS TX 75397-1342 CHECK NUMBER: 221951
CHECK DATE: 7/17/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4238900 20690384 20 . 37 OTHER MAINT SUPPLIES
Dyna Systems SHIP TO Invoice
P.O. Box 655326 �BROOKSHIRE GOLF CLUB
Dallas, TX 75265-5326
1800) 336-0450 RUSSEL PICKETT 1 of 1
LM
12120 BROOKSHIRE PKWY
A Partsma s ter Company, CARMEL, IN 46033
Division of NCH Corporation
9�131 Ace,Pa�
i
BILL TO REMIT TO: PO BOX 971342 o`O
F— BROOKSHIRE GOLF CLUB DALLAS TX 75397-1342 �ca�e Numbe��
BOB�HIGGINS `*Distribution services include shipping and handling
BROOKSHIRE PKWY charges.Returned merchandise not accepted without
12120
CARMEL IN KSHIR 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
20690384 06/19/13 DY305524 RUSSEL 07/19/13
ORDER # SHIP DATE SALES REP RELEASE # SHIP VIA
20614275-2 06/19/13 D202 D202!7387 FEDEX GROUND
FOR REORDERS CALL 1-800-336-0450 FAX 1-972-721-6870
. . .
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DY00722147 CAP SCREW DYNAMARK EA 0 20 20.37
SUB-TOTAL DISCOUNT MIN ORDER CHG SALES TAX **SHIPPING TOTAL
20.37 0.00 0.00 AMOUNT 20.37
+• — .p.7n n•. 4 T r rr r,rrnr A wrn P'U! 1 A t 1 V n IT
IL BOTTOM f'ORTrOr'.4JI h' Yl.?.l'4 �?A- � ��` -
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t`� � C+ :�'f,�r �,� '�5"A- F.,3�'� ''�fii'k� ✓"?gas �� �, fly.�» }`*n
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))
06/19/13 20690384 Repair Parts $20.37
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
Dyna Systems
IN SUM OF $
P.O. Box 971342
Dallas, TX 75397-1342
$20.37
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1207 20690384 I 42-389.00 I $20.37 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, July 02, 2013
:Z'-2 44k ,
Director, BrooksWrK Golf Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund