187062 06/23/2010 CITY OF CARMEL, INDIANA VENDOR: 362632 Page 1 of 1
ONE CIVIC SQUARE TREAT AMERICA FOOD SERVICES
8500 SHAWNEE MISSION PARKWAY CHECK AMOUNT: $123.39
CARMEL, INDIANA 46032
MERRIAM KS 66202 CHECK NUMBER: 187062
CHECK DATE: 6/23/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4239099 642344 15.83 OTHER MISCELLANOUS
1110 4355100 642344 .56 PROMOTIONAL FUNDS
852 5023990 642344 107.00 OTHER EXPENSES
INVOICE #642344
ROUTE 70604 70604
DRIVER 70045 FIELD, WILLIAM
06/11/2010 11:06am
Treat America
9702 East 30th Street
Indianapolis, IN 46229
CUSTOMER 372602
CARMEL POLICE DEPT.
3 Civic Square
Carmel, IN 46032
TERMS: CHARGE
DELIVERED
[PIN] ITEM CC PRICE QTY AMOUNT
[55523] MAXWELL HOUSE MASTERBLEND 4211.1 86635 42 26.50 3 79.50
[56638] AD CREAMER NON -DAIRY 12OZ SHAKER 1 1.75 5 8.75
[56640] AD SUGAR CANISTER (24/2002) 1 1.91 4 7.64
[55521] MAXWELL HOUSE DECAF 42/1.1 OZ 39039 42 27.50 1 27.50
TOTAL DELIVERED 13 123.39
TAX EXEMPT
TOTAL DEPOSIT .00
INVOICE TOTAL 123.39
NO PAYMENT RECORDED
"Thank you for your business"
CUSTOMER SIGNATURE:
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.
Payee
Treat America Purchase Order No.
9702 East 30th Street Terms
Indianapolis, IN 46229 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
6/11/10 642344 payment for coffee creamer and sugar 123.39
Total
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
Treat America IN SUM OF
9702 East 30th Street
Indianapolis, IN 46229
123.39
ON ACCOUNT OF APPROPRIATION FOR
1
Board Members
DEPT or INVOICE NO. ACC /TITLE AMOUNT I hereby certify that the attached invoice(s), or
1110 642344 5 (p bill(s) is (are) true and correct and that the
LJ materials or services itemized thereon for
which charge is made were ordered and
received except
June 16 20 10
&&',2 J� Q�' )t
Signature
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund