334352 01/10/19 4a u.EAA,yf I
CITY OF CARMEL, INDIANA VENDOR: 371006
ONE CIVIC SQUARE RPM PIZZA MIDWEST LLC CHECK AMOUNT: $********26.50*
CARMEL, INDIANA 46032 15384 FIFTH STREET CHECK NUMBER: 334352
GULFPORT MS 39503 CHECK(DATE: 01/1 0/19
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DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4239039 2532181220 26.50 GENERAL PROGRAM SUPPL
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ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
VOUCHER NO. WARRANT NO.
An invoice of bill to be properly itemized must show;kind of service,where performed,dates service rendered,by
Vendor# 371006 Allowed 20_ whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
RPM Pizza Midwest, LLC dba Domino's Payee
15384 Fifth Street
Gulfport;-MS-39503 In Sum of$- ---- --- - -- - -- - -
----Pure ase"Order#- ----- --- ---
371006 RPM Pizza Midwest, LLC dba Domino's Terms
$ 26.5U 15384 Fifth Street Date Due
Gulfport, MS 39503
ON ACCOUNT OF APPROPRIATION FOR
109-Monon Center
PO#or Invoice Description
Dept# INVOICE NO. ACCT#/TITLE AMOUNT Invoice Date Number (or note attached invoice(s)or bill(s)) PO# Amount
1096-70 2532181220 4239039 $ 26.50 Board Members 12/20/18 2532181220 Dinner for Playback Program 12/20/18 xx7746 $ 26.50
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
$ 26.50 Total $ 26.50
January 3,2019
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
Cost distribution ledger classification if
claim paid motor vehicle highway fund Signature 20_
Accounts Payable Coordinator Clerk-Treasurer
Title
a . '
RPM PIZZA MIDWEST LLC d/b/a DOMINO'S.
15384 Fifth Street ®_ 9
INUOIGE# 532-18122Q
Gulf I ort,
-DUE BATE 12/20/2018
'
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TOTAL AMOUNT, : , '.'$38.98 -
Bill to: Carmel Clay Parks.A Recreation
TOTAL DUE $38.98.
Attn: Carmel Clay Parks&-Recreation
1411E. 116th St:
Carmel,:IN 46032 : .. . . .
United States
Purch Ordmade.Recv-12/20/18-Monon'Community Center' ": $38.98
RECEIVED
By pschlemmer at 11:39 am, Dec 28, 2018
.10
1
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1NCORRECTI Y CHARGED: .CORRECT
CHARGE:
3 Pizzas-A $ 6.00=$-18.001 -
TOTAL AMOUNT: - 98'
1.Pizza @ $ 8:50 $ 8:50
ON
RPM PIZZA;MIDWEST- LLC d/b/a.D0MIN0'S
.15384 Fifth Street:.
Gulfport;MS 39503
United States
"
TOTAL DUE: $$;
Cusiom''er Id: 2532-0.02 AMOUNT ENCLOSED:'
Invoice.-#:2532-18:1220
Bill,to CarmelY.
Cla Parks,&:Recreatiori
Atth' Carniel Clay'Parks&Recreation -
1411.E.-116th St.:. . " ..
Carmel; IN 46032.'. . RPM.PIZZA:MIDWEST, LLC d/b/a DOMINO'S
United States . : H: '
Remit to: 15384 FIFTH STREET
GULFPORT, MS-39503
-Un States'
nak lieawalker .r �2. 28):832Questions:'ComPizza.com -4000
DATE:' :12/20/2018 TERMS:' DOE DATE; x:12/20/2018 .. PAGE