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J�( \.. CITY OF CARMEL, INDIANA VENDOR: 369028
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ONE CIVIC SQUARE AQUA FALLS BOTTLED WATER CHECK AMOUNT: $*******123.55*
CARMEL, INDIANA 46032 PO Box 98 CHECK NUMBER: 240926
.yi�oN. ENON OH 45323 CHECK DATE: 01/13/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1192 4355100 042575 123.55 PROMOTIONAL FUNDS
INVOICE
AQUA FALLS BOTTLED WATER
P.O. Box 98 Date: 11/20/2014 Invoice#042575
Enon OH 45323
Direct all inquiries regarding this invoice to
our accounting department at 937-864-5495
P.o.# ups order
Bill To Ship To
City Of Carmel Dept Comm Servi City Of Carmel Dept Comm Servi
1 Civic-Square - 1 Civic Square-
Carmel IN 46032 Carmel, IN 46032
/46032014/
Acct# 055041 -
Description Quantity Unit Price Taxable Amount
K-cup Cafe variety 1 @ 15.95 15.95
Kcup Hawaiian Bien 1 @ 12.95 12.95
kcup English Brea 1 @ 12.95 12.95
K cup Swiss Miss H 1 @ 14.95 14.95
k cup Dark Magic D 2 @ 12.95 25.90
K-cup Cafe Chai La 1 @ 14.95 14.95
Kcup Irish Breakfa 1 @ 12.95 _ 12.95
K cup Bob Marley L 1 @ 12.95 12.95
Invoice Total : 123.55
Previous Balance: 0.00
Acct Balance : 123.55_
VOUCHER NO. WARRANT NO.
ALLOWED 20
Aqua Falls Bottled Water
IN SUM OF$
P.O. Box 98
Enon, OH 45323
$123.55
ON ACCOUNT OF APPROPRIATION FOR
Carmel DOCS
PO#/Dept. INVOICE NO. ACCT#IrITLE AMOUNT Board Members
Prior Year I hereby certify that the attached invoice(s), or
1192 I 055041 143-551.00 I $123.55
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
1
i
Friday, January 09, 2015
,I
i
Director
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))
12/01/14 055041 $123.55
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