225853 11/05/2013 i
CITY OF CARMEL, INDIANA VENDOR: T358994 Page 1 of 1
ONE CIVIC SQUARE IGA/PGA, INC CHECK AMOUNT: $77.50
s` ~+ CARMEL, INDIANA 46032 PO BOX 516
FRANKLIN IN 46131 CHECK NUMBER: 225853
CHECK DATE: 11/5/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4355300 77 . 50 ORGANIZATION & MEMBER
Please Detach And Return Top Portion With Your Payment
INVOICE
CLUB NAME. BILL DATE DUE DATE
Brookshire Golf Club 10/28/2013 10/28/2013
REF# DESCRIPTION FEE
1313151 New Members 5 Standard members @ $18.50 $92.50
1313152 Existing members 208 Standard members @$0.00 $0.00
1313153 Online registrations (8/2-10/24) Credit for 1 Standard registration(s)@ ($15.00) ($15.00)
If you have questions about your account, call 317-738-9696. $77.50
Message(s):
The final revision for 2013 is November 15th. All fees and past due balances are due in the office by November 30th.
Thank you for your continued support.
Judy
r
Indiana Golf B®see ®/$c,
INNOV.invE'SYS iEIA,C!(YtfOL�
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))
10/28/13 Blue Golf Dues $77.50
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
r
VOUCHER NO. WARRANT NO.
ALLOWED 20
IGA-PGA
IN SUM OF $
Judy Deiwert
P.O. Box 516
Franklin, IN 46131
$77.50
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1207 I I 43-553.00 I $77.50 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
Monday, October 28, 2013
ate'
Director, Brookshl Golf Club
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund