189037 09/18/2010 CITY OF CARMEL, INDIANA VENDOR: 362632 Page 1 of 1
ONE CIVIC SQUARE TREAT AMERICA FOOD SERVICES CHECK AMOUNT: $67.48
CARMEL, INDIANA 46032 8500 SHAWNEE MISSION PARKWAY
MERRIAM KS 66202 CHECK NUMBER: 189037
CHECK DATE: 8/18/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4239099 642781 14.48 OTHER MISCELLANOUS
852 5023990 642781 53.00 OTHER EXPENSES
INVOICE #642781
ROUTE 70604 70604
DRIVER 70046 FIELD, WILLIAM
08/0,6/2010 G 11:64am
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
[56623] MAXWELL HOUSE MASTERBLEND 42/1.1 86636 42 26.60 2 63.00
[66638] AD CREAMER NON -DAIRY 120Z SHAKER 1 1.76 5 8.75
[56640] AD SUGAR CANISTER (24/20OZ) 1 1.91 3 6.73
TOTAL DELIVERED 10 67.48
TAX EXEMPT
TOTAL DEPOSIT .00
INVOICE TOTAL 67.48
NO PAYMENT RECORDED
"Thank you for your business"
CUSTOMER SIGNATURE:
PresBribed 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.
Payee
Treat America Purchase Order No.
.9702 Ear, 30th Street Terms
Indianapolis, IN 46229 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
816/10 642781 payment for coffee 67.48
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
T reat America IN SUM OF
9702 East 30th Street
Indianapolis, IN 46229
67.48
ON ACCOUNT OF APPROPRIATION FOR
police general fund police gift fund
Board Members
Poi or INVOICE NO. ACCT /TITLE AMOUNT
DEPT. 1 hereby certify that the attached invoice(s), or
1110 642781 390 --99 14.48 bill(s) is (are) true and correct and that the
852 642781 852 53.00 materials or services itemized thereon for
which charge is made were ordered and
received except
August 12 20 10
-'p 1). 7;�10"
Signature
Chief of Police
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund