185771 05/26/2010 CITY OF CARMEL, INDIANA VENDOR: 362576 Page 1 of 1
ONE CIVIC SQUARE HCO COFFEE TEA INC
I's CHECK AMOUNT: $25.00
CARMEL, INDIANA 46032 1114E 52ND ST
INDIANAPOLIS IN 46205 CHECK NUMBER: 185771
CHECK DATE: 5/26/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
902 4355100 CR02010 -5 25.00 COFFEE OFFICE
Invoice
Invoice Number:
HCO Coffee Tea CRD201.0 -5
1114 E. 52nd Street
Indianapolis, IN 46205 Invoice Date:
May 9, 2010
Page:
1
Sold To: Ship To:
CARMEL REDEVELOPMENT COMMISSION CARMEL REDEVELOPMENT COMMISSION
30 W. Main Street Suite 220 30 W. Main Street Suite 220
Carmel, IN 46032 Carmel, IN 46032
h(3 S5'iW
Customer ID Customer PO Payment Terms
CRD Net 30 Day
Sales Rep ID_ Sh ipping Method Ship Date,. ___._1 Due Date
WILB I Hand Deliver K-- 618110
Quantity Item Description Unit Price Extension
1.00 895000 EQUIP HCOAQUALIBRIUM 25.00 25.00
I
1
Subtotal 25.00
Sales Tax
ORDER ACCEPTED AS COMPLETE; CUSTOMER Shpg Hndlg
AUTHORIZED SIGNATURE DATE RECD
Total Invoice Amount 25.00
Payment Received 0.00
Check No: TOTAL 25.00
Prescribed by State Board of Accounts City Form No. 261 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or 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.
u
Payee
C C D �or rPC Purchase Order No.
52, Sfir Terms
�i9dr�sr��,00� 5, //lJ 25 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
/U C 02G /O 5
Total 2 S.UG
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.
20
Clerk- Treasurer
VOUCHER NO, WARRANT NO.
l/ ALLOWED 20
Co cc R 9 IN SUM OF
2 1 0,5�
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO4 or DEPT INVOICE NO. ACCT #/TITLE AMOUNT I hereby certify that the attached invoice(s), or
Q2 cR pza�� -5 5' 3S5 /DD 25� 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
i
U
20 io
Signature
Director of Redevelopment
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund