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Home My WebLink About225511 10/23/2013 CITY OF CARMEL, INDIANA VENDOR: 358941 Page 1 of 1 ONE CIVIC SQUARE PETTY CASH-BROOKSHIRE GOLF CO a CARMEL, INDIANA 46032 C/O PAM LISTER CK AMOUNT: $91.82 CHECK NUMBER: 225511 CHECK DATE: 10123/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1207 4239040 66 . 83 FOOD & BEVERAGES 1207 4350000 24 . 99 EQUIPMENT REPAIRS & M CLUB MANAGER RYAN SIMPSON (317) 585-1619 INDIANAPOLIS, IN Visit SamsClub.com 10/14/13 16:55 1277 8168 010 1758 V MEMBER 101-*******2662 THANK YOU, KATHY VASIL E 377608 ROMAINE I 3.90 N E 715920 AUNT'MILLIEF 3.48 N E 931469 HOT DOG BUNF-- 2.18 N E 931469 HCJ DOG BUNF 2.18 N E 931,169 HOOT DOG BUNF 2.18 N SUBTOTAL 13.92 TOTAL 13.92 MCARD TEND 13.92 ACCOUNT # 6670 APPROVAL # 62741P TERMINAL # MX285027 10/14/13 16:55:54 CHANGE DUE 0.00 Visit samsctub.com to see your savings # ITEMS TC# 7722 00228 1096 4812 IIIIIIII II IIIIIII IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII PI a tell us about your shopping experience http://www.survey.samsclub.00m IN TURN FOR YOUR TIME YOU COULD RECEIVE O OF FIVE$1,000 SAM'S CLUB SHOPPING CARDS M lb e 18 or older and a legal resident of the 50 US or to enter.No purchase necessary to enter or win.To enter without purchase and for official rules visit: www.entry survey.sa msclu b.corn Sweepstakes period ends on the date shown in the official rules.Survey must be taken within TWO weeks of today. a encuesta tambien se encuentra en espanol e a pagina de Internet. Sta nnected to Instant Savin, Sign at Samsclub.com/ema' 10 *** MEMBER COPY *** hI 4755 I::. 126"I'V ST. CA+;MIFI.., I 033 " s� CUSTOh1F.F: NUM?..P 40020008370 k WT 4011 AFJta J'1`: R[PE:: 1 .30 F 70051 F B :1 IFL.I 1JRL 3.79 F "' ** j I AX (i0 fAL 5.09 2.40 1 b @ . :,,9 (1 i FAIT W1 - CL 4011 f,IdAdFI'i' RIPE. 1 .30—F M,4 99( 3 RO1),I=F: .99 IF 1 R)41 GO EiAL 4.73 . RSEH 5.00 �• �`� x HACJ .27 TOTAL FIU'BEI? .IP IF[F1S SOLD = ? T 10/16/1 ? : -'? IIM 020 C11 004 ' 123 Y. OF :"C:III.R Wf'IS RSHLE:` THAN, )T.l'lI,J Frill". SHOPPING a CHECK IIS OIIT. I•,fth:/,'a ,ral.amirl.i as.c0m Wifl y:u.r• 11:rrsh FI ::,h Ide;zl Card You savi 6 t `lau have :;:reed t . Mai, >h Fre::h 1[1 A Carc ettlu rcI: for a: 1 offers. 1diuA f, !; 10U for S t 1CIPF'i l-13 M:1rsh VOUCHER NO. WARRANT NO. ALLOWED 20 Petty Cash IN SUM OF $ $18.65 ON ACCOUNT OF APPROPRIATION FOR Brookshire Golf Club PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1207 I Sam's I 42-390.40 I $13.92 1 hereby certify that the attached invoice(s), or 1207 I O'Malia I 42-390.40 I $4.73 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, October 21, 2013 71 q-,- �J /4 / Director, Bro hire 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)) 10/14/13 I Sam's I Food I $13.92 10/16/13 I O'Malia I Food I $4.73 1 hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accordance with IC 5-11-10-1.6 , 20 Clerk-Treasurer TOR SUPPLYC2 TractorSupply.com 18160 U.S. 31 NORTH WESTFIEI_D, IN 46079 317-867-3505 Ticket: 277983'W~^.-•- --------..__.___—._--..—�_-- lIzrle. 10%10/13 Time: 3:20 PM Score: 431 Register: 2 Cashier: 00235146 Customer: RUSSELL. PICKETT Phone k: 3174201676 Company: BROOKSHIRE GOLF Item Oty Price Amount HSK BELT 5/8X8$IN 4461876 1 24.99 29.99 E Subtotal 29.99 Tax 0.00 Total ~ - 24,99 -- T Cash 90.00 Change Cash (15.01 ) Tax Exempt Information Name: RUSSELL PICKETT Address: 12120 BERKSHIRE PARKWAY CiIj''St: CARMEL, IN Zip Code: 46032 Phone: 317-420-•1676 Tax Exempt Reason: Non--Profii/Exempt Or9 Expirattcn Date: Tax Exempt Holder: Under penalty of Perjury, signee declares the ileums he/,he has purchased the apptii_ahk_' Pruducts exempt from sales and use tax Ira-, beers done so with the enderstandiny ihat under state law he/she is attesling to having a valid exemption for ttc> purchased items. Additionally, the ccrsterr;er at tests that all iriformat ion he/sere has provided is accurate. Any willfully 7e representation of exemption or customer• information is subject to penalty under state law. `. This irrnsaction consists of one ar more items exempt from siaie sales or use tax. Before completing this transaction you attested that the information Provided, including name, address, and sales tax exemption number ( if necessary), is accurate. In addillon 1300 have declared that rims legally have a right to purchase the alcove items exempt from sales and use tax for the reason indicated as defined by This State's laws and regulations. Go to TractorSuPPIHSurvey.com or Call 1-877-789-1443 within 7 days to complete a survey and be entered in a monthly drawing for a chance to win a $25500 shopping spree. (Awarded as Gift Cards) Ends 12/31/2013 For complete details or to Participate without Purchase or survey, so to T rector°SuPPly.com/customersurvey Enter Store #: 0431 Enter Reference #: 02277483 SOLD ITEM COUNT = 1 11111�III I IIIII IIII III IIIII III MIIIIIII11 T1 LK91 KQ[iG4AM3I,1 i Please call 877-872-7721 for Customer Service. Styr; up now for ads; news, and more at 3 TraciorSupply.com Y Customer COPY AOL CLUB MANAGER RYAN SIMPSON (317) 585-1619 INDIANAPOLIS, IN Visit SamsClub.com 10/04/13 09:14 8529 8168 010 1860 V MEMBER 101-* A-1-2662 THANK YOU, KATHY VASIL E 377608 ROMAINE I 3.90 N E 680321 BROWNIE F 9.18 N E 931462 HAM BUNS F 2.18 N E 931462 HAM BUNS F 2.18 N E 931462 HAM BUNS F 2.18 N E 931469 HOT DOG BUNF 2.18 N E 931469 HOT DOG BUNF 2.18 N E 972893 SLICEDPROVOF 7.98 N SUBTOTAL 31.96 TOTAL ' 31.96 MCARD TEND 31.96 ACCOUNT # 6670 APPROVAL # 95253P TERMINAL # MX285027 10/04/13 09:15:36 CHANGE DUF Visit samsclub.com ,-- W MALTA #206 41'55 E. 126TH ST. CARMEL, IN 46033 (311')844-4372 4670 MM NFC OJ PULP FR NC 3.59 F 3. 13 It, @ 2. 49 /Ib WT 4799 rOMFiTOES HYDRO 7. 79 f CUSTOMER NUMBER 10020008370 SC 1586 MM NFC CiJ PULP FR 1 .10-F *e*> TAX .00 DAL 10.28 Sc 4 Mg Produce Palooza 1 .56-F * r TAX .00 DAL 8.72 CASH 20.00 CHANGE 11 .28 TOTAL NUMBER OF ITEMS SOLD = 2 10/11/13 10: 31 AM 0206 03 0030 163 YOUR CASHIER WAS MARGE YOU SAVED $ 22 . 66 ( 23% ) ON YOUR ORDER TODAY *� lc� YOUR SAVINGS #**#+tkx COUPON PLUS SAVINGS 1 .10 M-AMARKETPLACE: SAVINGS 1 .56 TOTAL. SAYINGS; (23%) S 2.66 YOUR SAVINGS +r * #** THANK YOU FOR SHOPPING O ' MALIA CHECK US. OUT: Fiftp://www.omalies.com With sour Marsh Fresh Idea Lard You saved $124.89 in 2012. You have saved 5204. 19 in 2013. Marsh Fresh IDEA Card required for all offers. Thank you for Shopping Marsh! ENTER MANNS BAKERY 5016 E 62ND ST iNDIANAPOL15 IN 4:39F'll OC'111' 8/1.3 00-7507 002 DIANA 12456.11, Moo @ $125 RB 24OZ M$7.50 *TTL of CASH $20.00 c H A N GE $f2.50 THANKS FOR SHOPPING AT ENTENNANNS BAKERY OUTLET STORES VOUCHER NO. WARRANT NO. ALLOWED 20 Petty Cash IN SUM OF $ $73.17 ON ACCOUNT OF APPROPRIATION FOR Brookshire Golf Club PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1207 Sam's 42-390.40 $31.96 1 hereby certify that the attached invoice(s), or 1207 Entenmanns 42-390.40 $7.50 bill(s) is (are) true and correct and that the 1207 I Tractor Supply I 43-500.00 I $24.99 materials or services itemized thereon for 1207 I O'Malia I 42-390.40 I $8.72 which charge is made were ordered and received except Tuesday, October 15, 2013 Director, Br shire 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)) 10/04/13 Sam's Food $31.96 10/08/13 Entenmanns Food $7.50 10/10/13 I Tractor Supply I Repair Parts I $24.99 10/11/13 I O'Malia I Food I $8.72 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