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250140 10/21/15 Q CITY OF CARMEL, INDIANA VENDOR: 00352899 ONE CIVIC SQUARE ADRIENNE KEELING CHECK AMOUNT: S"""'372.00' CARMEL, INDIANA 46032 C/o Docs CHECK NUMBER: 250740 C/o Docs CHECK DATE: 10/21/15 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1192 4357002 990013854216 372.00 EXTERNAL TRAINING FEE INVOICE Invoice#:99001385421604 STORE USE ONLY Event Date/Time: Order Number:9900138 10/13/2015 5:30PM Date Ordered: 10/12/201 4:10:36 PM Bill To: , CTR Delivery Company:City of Carmel Contact: Adrienne Keeling Customer:Adrienne Keeling Address: Address: 1 Civic Square Address: I Civic Square Address: Address: City,State Zip: Carmel, IN 46032 City,State,Zip: Carmel, IN 46032 Bus#:3174026629 Cell#: Home#: Contact#:3174026629 HA#: Not Applicable Directions: Quantity Description Cost I Lg Custom CC Sandwich $260.00 1 Lg CC Soup Choice $20.00 1 Small Box Traditional Tea $15.00 1 Box Old Fashioned Lemonade $15.00 Sign up for our eCafe Total Sales: $310.00 to receive all the latest Adjustments: $0.00 on what's happening at Delivery Fee: $31.00 Corner Bakery Cafe. Sales Tax: $0.00 www.cornerbakerycafe.com Sub-Total: $341.00 Your opinion is important! Gratuity: . 3,60 Go to www.cafefeedback.com Final Total: 3312.0' or call 866-306-6162 within 72 hours and tell us about your visit. You could Payments: win$2000.00 in our monthly drawing. Mastereard(4656)$341.00 Code:00000138990 GUEST SICNAT Print Name7m�(eo �CLP P—a, Store Information Food Safety Tips All Credit Card payments are Pre-authorized up to 30 Days in Advance and processed on the day of Delivery Clay'Terrace Consume or Refrigerate below 4 ll-,/5C 14550 Cla Terrace Blvd remit House Account payments to within 2 hours 9100 -reheat food to at least 165F/74C Cafe Patel,LLC Carmel.IN 46032 only once Tele:317-844-9930 5432 Ashby Ct Fax:317-844-9931 Greenwood, IN 46032 Email: cornerbakmcafcI604 a gmail.com Discard after 48 hours S4:20120227 Date/Time Pr;nted: 10/13/2015 7:43:46 AM uttnnII)nz,)u j 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)) 10/12/15 99001385421604 Dialog Dinner $372.00 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 $372.00 A. ON ACCOUNT OF APPROPRIATION FOR Carmel DOCS PO#/Dept. INVOICE NO. I ACCT#/TITLE AMOUNT Board Members 1192 1990013854216041 43-570.02 1 $372.00 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 I Thursday, Oct erM 2015 Director Title Cost distribution ledger classification if claim paid motor vehicle highway fund