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327670 07/20/18
`%'�,\F. CITY OF CARMEL, INDIANA VENDOR: 370103 J• ONE CIVIC SQUARE SOUTHERN ROCK RESTAURANTS LLC CHECK AMOUNT: $......*183.99* 9 ,a; CARMEL, INDIANA 46032 2355 E 116TH ST CHECK NUMBER: 327670 M�'ioN CARMEL IN 46032 CHECK DATE: 07/20/18 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1081 4239039 183.99 109507102018DK ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL VOUCHER NO. WARRANT NO. An invoice of bill to be properly itemized must show;kind of service,where performed,dates service rendered,by Vendor# 370103 Allowed 20 whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc. Southern Rock Restaurants, LLC Payee Attn:Jaime Clark 2355 E. 116th Street In Sum of$ Purchase order# Carmel, IN 46032 370103 Southern Rock Restaurants, LLC Terms $ 183.99 Attn:Jaime Clark Date Due 2355 E. 116th Street ON ACCOUNT OF APPROPRIATION FOR Carmel, IN 46032 108-ESE Fund PO#ornvolce Description Dept# INVOICE NO. ACCT#!TITLE AMOUNT Invoice Date Number (or note attached invoice(s)or bill(s)) PO# Amount 1081-99 109507102018DK 4239039 $ 183.99 Board Members 7/13/18 109507102018DK ESE Staff Training 7/10/18 xx7158 $ 183.99 I 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 $ 183.99 Total $ 183.99 July 18,2018 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 Cost distribution ledger classification if claim paid motor vehicle highway fund Signature 20_ Accounts Payable Coordinator Clerk-Treasurer Title RECEIVED Scut ern Rock Restaurants, LLC By pschlemmer at 1:07 pm, Jul 13, 2018 10 � ' (` ��' : Invoice No F1©95,i57�3�20F8© --� Pb*#/Order;Date. PO#XX-7158/07/10/2018 G .: . • Bill To: Carmel Parks Dawn Koepper :Attn:Jaime Clark ; Address: 1411_E..116thStreet 2355E 116th St l _ Carmel,.IN 46032 Carme In 46032 i .Phone: 317-573-4026 Phone:'(317)817=8000 'E-mail: dkoepper@carmelclay parks.co Cell:(317)441-2946 Description Units Cost Per Unit Amount LARGE SPUD MAX BAR 14 $10.00 - $ - -- 140.00 SMALL COOKIE TRAY .. 1 $11.99 $ 11.99. .. GALLONS W/WORKS 2 $7.50 T. 15.00'. GALLONS NO WORKS — 2 .. $6:00 $ 12.00. .. DELIVERY FEE . „ . 1 5.00 $ :. 5.00'. . PO_#XX=7158 . TAX'EXEMPT#: 0119683083-00.1 Invoice Subtotal: $ 183.99 Tax Rate - 0.00%. . Sa les.Tax $ 183.99. a e a c ec s ,a a e to Sout ern Roe estaurants, LC Total_due in 15 days:Overdue accounts subject to a service charge of 2%per month. Thank you for your business!