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191868 11/10/2010 CITY OF CARMEL, INDIANA VENDOR: 362632 Page 1 of 1 ONE CIVIC SQUARE TREAT AMERICA FOOD SERVICES CARMEL, INDIANA 46032 8500 SHAWNEE MISSION PARKWAY CHECK AMOUNT: $90.09 MERRIAM KS 66202 CHECK NUMBER: 191868 CHECK DATE: 11/10/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1110 4239099 29638 5.55 OTHER MTSCELLANOUS 852 5023990 29638 84.54 OTHER EXPENSES NOV. 2. 2010 7:52AM CRYSTAL FOODS INVOICE NO. 529 P. 2 Treat America Food Services 8500 Shawnee Mission! Parkway Suite 100 Merriam KS 66202 PLEASE RETAIN THIS INVOICE FOR PAYMENT DRIVER: Lowry, Ryan ACCOUNT NUMBER_ 372602 INVOICE DATE 11/03/10 INVOICE NUMBER: 29638 DELIVER TO: MAIL TO: Carmel Police Dept. Carmel Police Dept. 3 Civic Square 3 Civic Square Carmel, IN 46032 Carmel, IN 46032 TERMS Charge PO ROUTE: 70603 NEXT DELIVERY DATE: PRODUCT CSCNT QTY PRICE TOTAL 55521 MAXWELL HOUSE DECAF 42/1.1 OZ 39039 1 1 $28.88 $28.88 55523 MAXWELL HOUSE MASTERBLEND 42/1.1 $66 42 2 $27.83 $55.66 56638 AD CREAMER NON -DAIRY 120Z SHAKER 1 3 $1.85 $5.55 SIGNATURE SUBTOTAL $90.09 TAX ORDER TOTAL $90.09 REMIT TO: Treat America Food Services 8500 Shawnee Mission Pkwy Suite 100, Merriam, KS 66202 Inquiries? Please call (886y 384 -8237 THANK YOU FOR YOUR BUSINESS! Prescribed by Stale 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 Food Services Purchase Order No. 8500 Shawnee Mission Parkway, Suite 100 Terms Merriam;. KS 66202 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 11 /3/10 29638 payment for coffee, creamer 90.09 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 Food Services IN SUM OF 8500 Shawnee Mission Parkway, Suite 100 Merriam, KS 66202 90.09 ON ACCOUNT OF APPROPRIATION FOR police general fund police gift fund Board Members Po# or INVOICE NO. ACCT /TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or 1110 29638 390 -99 5.55 bill(s) is (are) true and correct and that the 852 29638 852 84.54 materials or services itemized thereon for which charge is made were ordered and received except November 4 20 10 Signature Chief of Police Cost distribution ledger classification if Title claim paid motor vehicle highway fund