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173177 06/09/2009 CITY OF CARMEL, INDIANA VENDOR: 358595 Page 1 of 1 ONE CIVIC SQUARE CARMEL CLAY FOOD NUTRITION SERA CARMEL, INDIANA 46032 5201 E 131ST STREET CHECK AMOUNT: $8,213.37 CARMEL IN 46033 CHECK NUMBER: 173177 CHECK DATE: 6/9/2009 D EPARTMEN T ACCOUNT PO NUM BER INV OICE NUMB A MOUNT DESCRIPTION 1046 4239040 041409 8,213.37 FOOD BEVERAGES Carmel Clay Schools Food Nutrition Service Invoice SCHOOL: Parks and Recreation DATE: April 14, 2009 FUNCTION: Breakfast /Snacks March 2009 BILL TO: Ben Johnson Name: Amy Anderson Address: ESC ORDERED NUM DESCRIPTION COST TOTAL Before School Breakfast 144 Free $0.00 $0.00 8 Reduced $0.30 $2.40 1,065 Paid $1.25 $1,331.25 1217 TOTAL $1,333.65 After School Snacks 966 Free $0.00 $0.00 248 Reduced $0.33 $81.84 10,269 Paid $0.66 $6,777.54 11,483 TOTAL $6,859.38 Extra Billing College Wood 8oz Milk Cartons (left out overnight) 54 $0.2S $13.50 Granola Bars (67 snacks, 103 missing from case) 36 $0.19 $6.84 GRAND TOTAL $8,213.37 Purchase escriPtkn "j P.O. PQrp MAY 2 1 2009 0 G.L. 1�--1 Cam oc)- Budget Bpo Line Destx Purchaser Approval 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 whom, 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. 131 st St. Date Due Carmel, IN 46033 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO Amount 4/14/09 Mar'09 Breakfast/Snacks Mar'09 20879 8,213.37 Total 8,213.37 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 ucher No. Warrant No. 35S5C1 58595 Carmel Clay Schools Food Nutrtion Allowed 20 5201 E. 131 st St. Carmel, IN 46033 In Sum of 8,213.37 ON ACCOUNT OF APPROPRIATION FOR 104 Program Fund PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members Dept 1046 Mar'09 4239040 8,213.37. 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 4 -Jun 2009 Signature 8,213.37 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund