178575 10/27/2009 CITY OF CARMEL, INDIANA VENDOR: 358595 Page 1 of 1
ONE CIVIC SQUARE CARMEL CLAY FOOD NUTRITION SE�y
CARMEL, INDIANA 46032 5201 E 131ST STREET CHECK AMOUNT: $12,505.89
CARMEL IN 46033 CHECK NUMBER: 178575
CHECK DATE: 10/27/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUN D ESCRIPTION
1046 4239040 OCT 09 12,505.89 FOOD BEVERAGES
Carmel Clay Schools Food Nutrition Service Invoice
SCHOOL: Parks and Recreation DATE: November
FUNCTION: Breakfast /Snacks October 2009 BILL TO: Ben Johnson
Name: Amy Anderson
Address: ESC
ORDERED NUM DESCRIPTION COST TOTAL
Before School Breakfast
251 Free $0.00 $0.00
163 Reduced $0.30 $48.90
1,728 Paid $1.25 $2,160.00
0 TOTAL $2,208.90
After School Snacks
1,117 Free $0.00 $0.00
659 Reduced $0.33 $217.47
15,272 Paid $0.66 $10,079.52
0 TOTAL $10,296.99
O GRAND TOTAL $12,505.89
Purchase y 1 7 1-7 r'
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Description
P.O. C-/Z- 394 OCT 1 1009
131. y CQ 1 d�
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Line Descr Ly
Purchaser
E t e .pproval e
OCT 1 9 2009
BY
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of bill to be properly itemized must show; kind of service, where performed, dates service rendered, by
Morn, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
358595 Carmel Clay Schools Food Nutrtion Terms
5201 E. 131st St. Date Due
Carmel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
10/16/09 Oct'09 Breakfast/Snacks Oct'09 12,505.89
Total 12,505.89
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
'oucher No. Warrant No.
358595 Carmel Clay Schools Food Nutrition Allowed 20
5201 E. 131 st St.
Carmel, IN 46033
In Sum of
12,505.89
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept
1046 Oct'09 4239040 12,505.89 1 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
22 -Oct 2009
AA
Signature
12,505.89 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund