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250306 1 0/07/1 5r CITY OF CARMEL, INDIANA VENDOR: 00352899 ` ONE CIVIC SQUARE ADRIENNE KEELING CHECK AMOUNT: $.....w.*27 70" .�; ® `il• CARMEL, INDIANA 46032 C/O DOCS CHECK NUMBER: 250306 C/O DOCS CHECK DATE: 10/07/15 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1192 4355100 27.70 PROMOTIONAL FUNDS u� Kolache Factory #074 Locally Owned and Operated 890 E 116th St, #100 Carmel, IN 46032 317-816-2253 434 Host: Shared4 10/02/2015 434 8:17 AM 40034 Sausage (6 @1 .00) 6.00 , Fruit (9 @1 .25) 11 .25 : Jalapeno Popper (3 @1 .80) 5.40; Bacon & Cheese (3 @1 .55) 4.65, Sausage & Cheese (3 01 .70) 5.10' Dozen Disc -3.24 MGR COMP a Sub Total 27.70 Tax 0.00 Order Total 27.70 27,70 Auth:08425P Thank You For Choosing Kolache Factory a history of good taste. Franchises Available kolachefactory.com --- Check Closed --- 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)) 10/02/15 $27.70 i 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 Adrienne Keeling IN SUM OF $ c/o One Civic Square Carmel, IN 46032 $27.70 ON ACCOUNT OF APPROPRIATION FOR Carmel DOCS PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1192 43-551.00 $27.70 I hereby certify that the attached invoice(s), or I I I 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 Monda , Oc ber 5, 2015 Direct Title Cost distribution ledger classification if claim paid motor vehicle highway fund