164710 10/16/2008 CITY OF CARMEL, INDIANA VENDOR: 355466 Page 1 of 1
ONE CIVIC SQUARE KEITH FREER CHECK AMOUNT: $68.67
CARMEL, INDIANA 46032 1413 N. FAIRVIEW STREET
ALEXANDRIA IN 46001 CHECK NUMBER: 164710
CHECK DATE: 10116/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION i
851 5023990 68.67 OTHER EXPENSES
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Papa Johns
Restaurant #1485
10598 North College Avenue
Indianapolis, IN 46280
(317) 846 -7272
356869 09/30/2008 11:29am
InStore Order
Name: Keith
Restaurant Order 0007
Reference 86789
Batch ID: 0
Order Amount: 63.00
Tax: 5.67
S Total Amount: 68.67
Mastercard: 68.67
ro Tip:
Total:
bO Addtl Tender Amt: 0.00
Customer Signature
X
Customer Copy
I agree to pay total amount according to
the card issuer agreement.
Thank You For Choosing
Papa Johns
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
f
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 l have audited same in accordance
with IC 5- 11- 10 -1.6.
20
Clerk- Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN SUM OF
ON ACCOUNT OF APPROPRIATION FOR
Board Members
0
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I 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
20
r..7
igna re
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund