159842 05/28/2008 CITY OF CARMEL, INDIANA VENDOR: 359587 Page 1 of 1
ONE CIVIC SQUARE CROSSROADS CIGARS CHECK AMOUNT: $58.45
o. CARMEL, INDIANA 46032 24555 HUDSON STREET
SHERIDAN IN 45069
CHECK NUMBER: 159842
CHECK DATE: 512812008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
905 4239040 5908 58.45 FOOD BEVERAGES
I
Crossroads Cigars
24555 Hudson St,
Sheridan, IN 46069
317 -440 -8834
crossroadscigars@aol.com
INVOICE rooKSh;1 GC INVOICE
Date: 26
Job Number: j
TO: FROM:
o
DATE
QTY. INVENTORY DESCRIPTION SOLD COST RETAIL BALANCE
C��,}� 1 4,70
f./ C
x S 5 b v rt oD
BALANCE DUE 5
CUSTOMER SIGNATURE I
*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
359587 Purchase Order No.
Crossroads Cigars
24555 Hudson St Terms
Sheridan IN 46069 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
14 S909
Total '5T `/5
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
A VOUCHER NO. WARRANT NO.
ALLOWED 20
359587 IN SUM OF
Crossroads Cigars
24555 Hudson St
Sheridan IN 46069
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO4 or P Pr. a INVOICE NO. ACCT #!TITLE AMOUNT I hereby certify that the attached invoice(s) or
907 Vr 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
2VY
Si nature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund