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159805 05/28/2008 CITY OF CARMEL, INDIANA VENDOR: 356880 Page 1 of 1 ONE CIVIC SQUARE CALDERON BROTHERS VENDING CO CHECK AMOUNT: $127.75 CARMEL, INDIANA 46032 9702 E 30TH STREET INDIANAPOLIS IN 46229 -1030 CHECK NUMBER: 159805 CHECK DATE: 5/28/2008 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOU D ESCRIPTION 1110 4355100 60409572 127.75 PROMOTIONAL FUNDS r Prescribed by State Board of Accounts City Form No. 201 (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 Calderon Brothers Vending Co. Purchase Order No. 9702 E. 30th Street Terms Indianapolis, IN 46229 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 5/16/08 60409572 payment for coffee 127.75 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. wF ALLOWED 20 Calderon Brothers Vending Co. IN SUM OF 9702 E. 30th Street Indianapolis, IN 46229 127.75 ON ACCOUNT OF APPROPRIATION FOR police general ufnd Board Members Pori or INVOICE NO. ACCT #/TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or 1110 60409572 551 127.75 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 May 19 20 08 Signature Chief of POlice Cost distribution ledger classification if Title claim paid motor vehicle highway fund