163693 09/17/2008 CITY OF CARMEL, INDIANA VENDOR: 359587 Page 1 of 1
4 ONE CIVIC SQUARE CROSSROADS CIGARS CHECK AMOUNT: $166.95
CARMEL, INDIANA 46032 8074 MALLARD LANDING
INDPLS IN 45278 CHECK NUMBER: 163693
CHECK DATE: 9/17/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOU DESCRIPTION
1150 4239099 6238 70.00 OTHER MISCELLANOUS
1150 4239099 7158 96.95 OTHER MISCELLANOUS
I
From:STATE BK OF LIZTON ,3178581048 09/11/2008 11:05 #305 P.0011002
r Cmssraads Cigars
8074 Mallard Landing
IndWngdIs, IN 48278
�v 317- 4404834
crossrpedsaigar@aol.com
INVOICE Gc INVOICE# 623
Date: to 4
Jab Number
TO: �a b s FROM OCj
DATE
QTY. INVENTORY DESCRIPTION SOLD COST q;A�ANC;E
l; 4 rf,
6a.
c0 l I o U 3 s C7 0
MrL
I� �ctnc�d '�?�busfio ,tea
d y
Y, 5S
BALANCE DUE Ica. y0
CUSTOMER SIGNATURE
-Complete payment due within 30 days above 2nd i date. Payments received after 30 days
will be assessed a 5% penatty.
_317
�I ��I,0 ow
From:STATE BK OF LIZTON 3178581048 09111/2008 11:05 #305 P.0021002
Crossroads Cigars
8074 Mallard Landing
Indianapolis, IN 46278
317-440-8834
crossroadscigars@aol.com
INVOICE rc;b 6 f CG INVOICE 7 IS'
Date:
Job Number.
7 a j
T0: f FROM.
DATE:
QTY. INVENTORY DESCRIPTION SO;L�D� COST RETAIL BALANCE
7
C Z i .00
t 0,
BALANCE DUE,
CUSTOMER SIGNATURE
'Complete payment due within 30 dell above 2nd invoice date- Payments received after 30 days
will be assessed a 5% penalty.
P[escribed 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
phom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
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
S� IN SUM OF
F
qJ
ON ACCOUNT OF APPROPRIATION FOR
I
Board Members
PO# or INVOICE NO. ACCT /TITLE AMOUNT
DEPT. k hereby certify that the attached invoice(s), or
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
2a
Signature
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund