186671 06/21/2010 CITY OF CARMEL, INDIANA VENDOR: 362576 Page 1 of 1
fj ONE CIVIC SQUARE HCO COFFEE TEA INC CHECK AMOUNT: $25.00
a CARMEL, INDIANA 46032 1114 E 52ND ST
y4;11an_�o`. INDIANAPOLIS 1N 46205 CHECK NUMBER: 186671
CHECK DATE: 6/21/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
902 4355100 CRD2010 --6 25.00 COFFEE
I
Invoice Number:
HCO Coffee Tea
1114 E. 52nd Street CRD2010 -6
Indianapolis, IN 46205 Invoice Date:
Jun 9, 20] 0
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
Customer ID Customer PO Payment Term
CRD Net 30 Da
ales-R-ep ID Sh inning- Metho 1 Ship -rate Date
WILB T Hand Deliver i 7/9/10
F__ quantity _I Item Description Unit Pr 1 Extension
1.00 1 895000 EQUIP HCO AQUALIBRIUM 25.00 25.00
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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 ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
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.
Payees fi
v
C c i i e_e_ y T� Purchase Order No.
1 E, Terms
w)4y% NWI_3. IN q6 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
H a m
Total 4 G
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.
ALLOWED 20
H 6 c c �I L �T fe,e. eti
IN SUM OF
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2-57ea
ON ACCOUNT OF APPROPRIATION FOR
Pay from Cash
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Board Members
Po# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
C 0 25, CG bills) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
z received except
20 le
Si tore
nirectorof of
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund