300028 07/12/16 r_Cqq
CITY OF CARMEL, INDIANA VENDOR: 365313
® ONE CIVIC SQUARE BLU MOON CAFE CHECK AMOUNT: $*****6,520.00*
4 'Q CARMEL, INDIANA 46032 200IS RANGELINE RD CHECK NUMBER: 300028
SUI7T,E 115
CA MEL IN 46032 CHECK DATE: 07/12/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
854 4359037 062416CARMEL 6,520.00 USCM ANNUAL MEETING 2
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
BLU MOON CAFE ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
200 S RANGELINE RD IN SUM OF$ CITY OF CARMEL
SUITE 115 An invoice or bill to be properly itemized must show:kind of service,where performed,dates service
CARMEL, IN 46032 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
$6,520.00 Payee
ON ACCOUNT OF APPROPRIATION FOR Purchase Order#
Community Relations Terms
Date Due
PO# ACCT# DATE INVOICE# DESCRIPTION
DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT
062416CARMEL 43-590.37 $6,520.00 1 hereby certify that the attached invoice(s),or 6/24/16 062416CARMEL $6,520.00
1203 854 1203 854
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
Wednesday,July 06,2016
V
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
Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer
Blu Moon Cafe Invoice No. 062416CARMEL
200 S. Rangeline Rd Ste. 915
C A F E Carmel, IN 46032
317-844-8310
INVOICE
Customer Misc
Name City of Carmel I Date 6/24/2016
Address Mayor Conference After Party Order No.
City State Zip
Phone
Qty Description Unit Price TOTAL
600 Custom Light Hor D Menu $ 16.00 $ 9,600.00
INKIND Donation is provided by Pedcor Corporations
SubTotal $ 9,600.00
Gratuity 20% $ 1,920.00
Payment Tax Rate(s) 0.00% $ :IN KIND DONATIONS $ 5,000.00
Comments Payment is due upon receipt of service.
Credit card are required to have on file TOTAL $ 6,520.00
for any event paying with a check or
cash the day of the event.
Please confirm with sign copy of invoice or confirmation email that the above information is correct and agreed upon.
I
Thank you for your business!