253074 01/11/16 CITY OF CARMEL, INDIANA VENDOR: 370172
® ONE CIVIC SQUARE H & H COFFEE SERVICE CHECK AMOUNT: $*******250.00*
CARMEL, INDIANA 46032 7902 wwDHILL DRIVE CHECK NUMBER: 253074
9M�TON�. INDIANAPOLIS IN 46256 CHECK DATE: 01/11/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
102 4467099 4631 250.00 OTHER EQUIPMENT
H & H COFFEE SERVICE 4631
7902 WINDHILL DRIVE
Date INDIANAPOLIS,INDIANA 46256
317-849-3440 • FAX:317-849-8810
FRANK HUBER
Customer: CITY
Address: f
Quantity Description Price Amount
Coffee-Reg.
Coffee -Decafe
Coffee-Flavored
Cream
Sugar
Cream-Flavored
Sweet&Low
Hot Chocolate
Tea
Stir Stix
Cups
Decanters
Fuel Charge
Sub'Total
Tax
Total j j,5�
Received By:
Thank You
VOUCHER NO. WARRANT NO.
ALLOWED 20
H & H Coffee Service
IN SUM OF$
7902 Windhill Drive
Indianapolis, IN 46256
9 $250.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1120 4631 102-670.99 $250.00 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
JAN — 4 2016
d 1 k A A
v�
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
'rescribed by State Board of Accounts City Form No.201 (Rev.1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
kn invoice or bill to be properly itemized must show: kind of service,where performed, dates service rendered, by
vhom, 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))
4631 Sta.43 $250.00
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