328000 07/25/18 v`%���p � CITY OF CARMEL, INDIANA VENDOR: 372597
® ONE CIVIC SQUARE LARAZA PIZZA INC CHECK AMOUNT: $********83.39
f� �, CARMEL, INDIANA 46032 P.O.BOX 780723 CHECK NUMBER: 328000
9�'�ioN"�O` WICHITA KS 67278 CHECK DATE: 07/25/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 0751219803 83.39 OTHER EXPENSES
VOUCHER NO. 182191 WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev 1995)'
ALLOWED 20
Vendor # 372597 IN SUM OF$ ACCOUNTS PAYABLE VOUCHER
STORE #28451 LARAZA PIZZA INC CITY OF CARMEL
PO BOX 780723 An invoice or bill to be properly itemized must show: kind of service,where performed,
WICHITA, KS 67278 dates service rendered, by whom, rates per day, number of hours, rate per hour,
numbers of units, price per unit,etc.
Payee
83.39 372597 Purchase Order No.
ON ACCOUNT OF APPROPRATION FOR STORE#28451 LARAZA PIZZA.INC Terms
.Carmel Water Utility PO BOX 780723 Due Date
BOARD MEMBERS
I hereby certify that that attached invoice(s), WICHITA, KS 67278
or bill(s)is(are)true and correct and that
PO# ACCT# the materials or services itemized thereon for DATE INVOICE# Description
DEPT# INVOICE# Fund# AMOUNT which charge is made were ordered and DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT
0751219803 01-4611-00 $83.39 and received except 7/19/2018 0751219803 $83.39
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. 20_
Clerk-Treasurer
Carmel Utilities
Account Number 0751219803
P.O. Box 109 Carmel, IN 46082-0109
Amount Due
Customer Service
www.carmelutilities.com (317) 571-2442 • e Date
Mon-Fri 8am-5pm Amount Due
After Due Date
STORE#28451 LARAZA PIZZA INC Service Address
P O BOX 780723 705 S RANGE LINE RD
WICHITA, KS 67278
FINAL
PeriodService Meter Meter Readings
Number
PAYMENT RECEIVED, THANK YOU (196.50)
05/06/18 06/05/18
PREVIOUS BALANCE CREDIT (83.39)
0
0