227484 12/17/2013 ���,F CITY OF CARMEL, INDIANA VENDOR: 367098 Page 1 of 1
ONE CIVIC SQUARE RESIDEX LLC CHECK AMOUNT: $275.00
CARMEL, INDIANA 46032 46495 HUMBOLDT DR
''., '+° NOVI MI 48377-2446 CHECK NUMBER: 227484
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CHECK DATE: 12/17/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4238900 INV333683 275 . 00 OTHER MAINT SUPPLIES
Invo�ce���n 'INV333683
Residey.0, RESIDEX, LLC Date , 11/5/2013
Jacksonville, FL Branch Page m`2/Z
7380 Philips Highway
Jacksonville,FL 32256-6833
(904)296-2501
Bill To: Ship To:
BROOKSHIRE GOLF COURSE BROOKSHIRE GOLF COURSE
12120 BROOKSHIRE PKWY 12120 BROOKSHIRE PKWY
CARMEL,IN 46033-3314 CARMEL, IN 46033-3314
(317)571-2414 Contact: CINDY SHEEKS
(317)846-7431 (317)571-2414
(317)846-7431
PO Number;, Customer TD Salesperson 1D , Shipping^Method,sPaymeritlerms DueaDate RegSh�p Date,_ _Entered;B,yw
EL 6 BR0425 CHRISS OUR TRUCK NET 30 DAYS 12/5/2013 10/29/2013 kanno��
$p
Delivery Waiver on file 7/2013Signed by: Robert Higgins
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Unit at Descrt tion35,,,,.,v �,.;Q �.• r UofNl_ ,s r., ,ric 4.w6&,Ext,,,Price,
1.00 AA1003 Turf Fuel Element 6(2.5 gal,2 per case) CS $275.00 $275.00
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Subtotal $275.00
Tax $0.00
PLEASE REMIT TO.- Total $275.00
Programs offering early payment discounts are based RESIDEX LLC Payments $0.00
on product subtotal, before sales tax,as sales tax is 46495 HUMBOLDT DR Invoice Balance $275.00
not discountable. NOVI, MI 48377-2446
VOUCHER NO. WARRANT NO.
ALLOWED 20
Residex LLC
IN SUM OF $
46495 Humboldt Dr.
Novi, MI 48377-2446
$275.00
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1207 I INV333683 I 42-389.00 I $275.00 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
Monday, December 16, 2013
Director, Brookshlre 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))
11/05/13 I INV333683 I Fertilizer I $275.00
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