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301978 08/18/16
�°y F�gb CITY OF CARMEL, INDIANA VENDOR: 371006 \'` ONE CIVIC SQUARE RPM PIZZA MIDWEST LLC CHECK AMOUNT: $*******276.00* r, �; CARMEL, INDIANA 46032 15384 FIFTH STREET CHECK NUMBER: 301978 yy,(iON`CO� GULFORT MS 39503 CHECK DATE: 08/18/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1082 4239039 2532-160729 126.00 GENERAL PROGRAM SUPPL 1082 4239039 2532-160729A 150.00 GENERAL PROGRAM SUPPL Voucher No. Warrant No. RPM Pizza Midwest, LLC dba Domino's Allowed 20 15384 Fifth Street Gulfort, MS 39503 In Sum of$ $ 276.00 ON ACCOUNT OF APPROPRIATION FOR 108 -ESE PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members Dept# 1082-9 2532160729 4239039 $ 126.00 1 hereby certify that the attached invoice(s), or 1082-15 2532160729a 4239039 $ 150.00 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 August 10, 2016 1PAH1*lJX-&U Signature $ 276.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice of 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. RPM Pizza Midwest, LLC dba Domino's Terms 15384 Fifth Street Gulfort, MS 39503 Invoice Invoice Description Date Number (or note attached invoice(s)or bill(s)) PO# Amount 7/29/16 2532160729 Last Day of Camp Celebration 7/29/16 xx4108 $ 126.00 7/29/16 2532160729a WIA Lunch Fun Friday Celebration 7/29116 xx4139 $ 150.00 Total $ 276.00 1 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 z • RPM=PIZZA�MIDWEST;LLCdlb/a DOMINO'S a�. �- �� INVOICE'# 2532=160729 15384 Flfth Street F ©ATE 07/29/2018 Gulfport;MS 39503 x x DUE-DATE --0712912016 TOTAL AMOUNT: $126.00 Bill to: Carmel Clay Parks& Recreation TOTAL DUE $126.00 Attn: Carmel Clay Parks& Recreation 1411 E. 116th St. � 3 - �– Carmel, IN 46032 United States AUG W5 2016 BY: Purch Ord/Trade Recv-07/29/16-Purch Ord/Trade Recv-Monon Community Center $126.00 TOTA`t AIVIOl1N7: $126A0 RPM PIZZA MIDWEST, LLC d/b/a DOMINO'S 15384 Fifth Street Gulfport, MS 39503 United States TOTAL DUE: $126.00 Customer Id: 2532-002 AMOUNT ENCLOSED: Invoice#:2532-160729 Bill to: Carmel Clay Parks& Recreation Attn: Carmel Clay Parks&Recreation 1411 E. 116th St. �� o Carmel, IN 46032 LL diaiD011 NO'S United States mit=t6.,—T 538'4 FIFTHII-MIR-E�Ti� Ad ULFPORT~`IVIS 39� 503 United-States" Questions: Contact kyliea.walker@rpmpizza.com (228) 832-4000 DATE: 07/29/2016 TERMS: DUE DATE: 07/29/2016 PAGE 1 INVOICE RPM PIZZA MIDWEST, LLC d/b/a DOMINO'S NVEHOgj# 2532„11 07rz a 15384 Fifth Street 7� z 4E 07/29/2018 Gulfport, MS 39503 DUE'DATE 07/29/20 6 TOTAL AMOUNT: .99 a Bill to: Carmel Clay Parks& Recreation --------- - TOTAL DUE $1 .99 Attn: Carmel Clay Parks&RecreationrAUG 1411 E. 116th St.Carmel, IN 46032 0`5 2016 United States i Purch Ord/Trade Recv-07/29/16-Purch Ord/Trade Recv-Carmel Elementary ^ 5- v TOTAL AMOUNT: $j 99 RPM PIZZA MIDWEST, LLC d/b/a DOMINO'S �7a�, 0 15384 Fifth Street Gulfport, MS 39503 United States TOTAL DUE: , Customer Id: 2532-002 AMOUNT ENCLOSED: Invoice#:2532-160729a Bill to: Carmel Clay Parks & Recreation Attn: Carmel Clay Parks & Recreation 1411 E. 116th St. Carmel, IN 46032 P PP MIbWEST'LLC d/b/a;DOMINOWS United States Remrt to 1538' 4�'FIFTH,STRE-ENT'' FRGULFPOR¢T,MS 39A5A03 United aStates � f fI� y Questions: Contact kyliea.walker@rpmpizza.com (228) 832-4000 DATE: 07/29/2016 TERMS: DUE DATE: 07/29/2016 PAGE 1