160316 06/10/2008 CITY OF CARMEL, INDIANA VENDOR: 359587 Page 1 of 1
ONE CIVIC SQUARE CROSSROADS CIGARS
I; 0 CHECK AMOUNT: $134.75
CARMEL, INDIANA 45032 8074 MALLARD LANDING
INDPLSIN 46278 CHECK NUMBER: 160316
CHECK DATE: 6/10/2008
DEPARTMENT ACCOUNT PO NUMBER INVOI NUMBER AMOUNT DESCRIPTION
905 4239040 6408 134.75 FOOD BEVERAGES
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Crossroads Cigars "+?1�a;5 e— n''
8074 Mallard Landing c� U d X55
Indianapolis, IN 46278
317-440 -8834
crossroadscigars@aol.com
INVOICE rboY5h ,r G INVOICE 4 ads
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Date: S g lo
Job Number:
TO: FROM:
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DATE
QTY. INVENTORY DESCRIPTION c SOLD COST RETAIL BALANCE
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'06
rn ;'7
BALANCE DUE 1 �3 .7.5
CUSTOMER SIGNATURE
"Complete payment due within 30 days of above 2nd invoice date. Payments received after 30 days
will be assessed a 5% penalty.
Prescribed 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
Purchase Order No.
'Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
VoS /3/7.5
Total -3 cl 75
1 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
I/ IN SUM OF
/3 5! 7S
ON ACCOUNT OF APPROPRIATION FOR
90 .s 3(§-c-
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
OS to O 3 V0 bill(s) is (are) true and correct and that the
3 9 0 V0 materials or services itemized thereon for
which charge is made were ordered and
received except
�O 20 O
Signat e�
Cost distribution ledger classification if
Title
claim paid motor vehicle highway fund