174035 06/24/2009 CITY OF CARMEL, INDIANA VENDOR: 361935 Page 1 of 1
ONE CIVIC SQUARE SAHM'S RESTAURANT BAR CHECK AMOUNT: $946.46
CARMEL, INDIANA 46032 11590 ALLISONVILLE ROAD
a, e FISHERS IN 46038 CHECK NUMBER: 174035
CHECK DATE: 6124/2009
D EPARTMENT ACC OUNT PO NUMBER INVOICE NUM AMOUNT DESCRIPTION
1207 4.239040 32611 946.46 FOOD BEVERAGES
Invoice
Sahm' s Restaurant Bar Invoice Number:
11590 Allisonville Road
32611
Fishers, IN 46038
Invoice Date:
Jun 16, 2009
Voice: 317-842-1577
Fax: 317- 577 -8216 Page.
1
Duplicate
Sold To: Ship to:
Brookshire
12120 Brookshire Parkway
Carmel, IN 46038
Customer ID Customer PO Payment Terms
BROOKSHTRE Net--30- Days_
Sales Rep ID Shipping Method Ship Date 1 Due Date
Airborne 7/16/09
Quantity Item Description Unit Price Extension
ATTN. PAM LISTER
65.001100 Group A B 11.95 776.75
65.001170 Dessert tray, one item l.K 126.75
1.00002 Delivery, Set Up Pick Up 40.00 40.00
1.0 9003 ileage Surcharge 2.9E 2.9
Subtotal 946.46
Sales Tax 81.32
Total Invoice Amount 1,027.78
Check/Credit Memo No: Payment /Credit Applied
TOTAL 1,027.78
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
C S `��S y r�'j Purchase Order No.
5 q 0 Terms
V S 1. s lTl y 0 3 g Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
Total q9l .9&
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
VOUCHER NO. WARRANT NO,
ALLOWED 20
IN SUM OF
y(
ON ACCOUNT OF APPROPRIATION FOR
Co
Board Members
PON or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
3.b
3;) 1 390 V D 7v 6 �A 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
j �Sign0#ur
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund