167967 01/21/2009 CITY OF CARMEL, INDIANA VENDOR: 362445 Page 1 of 1
ONE CIVIC SQUARE DOMINO'S PIZZA
CARMEL, INDIANA 46032 841 S RANGELINE ROAD CHECK AMOUNT: $199.90
.9 /,r CARMEL IN 46032 CHECK NUMBER: 167967
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CHECK DATE: 1/21/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1046 4239037 CCP &R -0002 199.90 CLUB ACTIVITY SUPPLIE
e e
1
Domino's Pizza INVOICE
DATE: 11/7/2008
www.dominos.com INVOICE CCPEtR -0002
Customer ID 1
841 S. Rangrline Road
Carmel, In 46032
317 -846 -6100
317 816 -5305
g
Shavonne Holton Shavonne Holton
Carmel Clay Parks I* Recreation Carmel Clay Parks Et Recreation
1411 E. 116th Street 1411 E. 116th Street
Camel, IN 46032 Camel, IN 46032
317 258 -8266 317 258 -8266
Keith I CS103108 111/14/20081 Delivery I DUE IN 30 DAYS
Large Hand T ossed Cheese Pizzas 8 79.96
Large Hand Tossed Pepperoni Pizzas 8 79.96
Large Hand Tossed Sausage Pizzas 4 39.98
chase
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Line Deser
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Approval
SUBTOTAL 199.90
FOtherCom or p cia�l In TAX RATE Exempt
1. Total payment due in 30 days TAX
2. Please include the invoice number on your check S Et H
OTHER
TOTAL 199.90
Make all checks payable to
Domino's Pizza
If you have any questions about this invoice, please contact
James Shiflet 317 658 -3719 TTV
Thank You For Your Business!
DEC
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.
Domino's Pizza Terms
841 S Rangeline Rd
Carmel, IN 46032
Invoice Invoice Description
ate Number
or note attached invoice(s) ch or bill(s)) Amount
D
199.90
1117108 CCP &R -0002 Cljbs ppl ies
Total 199.90
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.
Domino's Pizza Allowed 20
841 S Rangeline Rd
Carmel, IN 46032
In Sum of
199.90
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1046 CCP &R -0002 4239037 199.90 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
2 -Jan 2009
Signature
199.90 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund