175903 08/06/2009 CITY OF CARMEL, INDIANA VENDOR: 362955 Page 1 of 1.
ONE CIVIC SQUARE, SOUTHERN FOOD SYSTEMS CHECK AMOUNT: $311.10
CARMEL, INDIANA 46032 PO BOX 19635
INDIANAPOLIS IN 46219 CHECK NUMBER: 175903
CHECK DATE: 81612009
DEPARTMENT ACCOU PO NUM INVOICE NUMBER AMOUNT DESCRIPTION
1047 4350000 120172 311.10 EQUIPMENT REPAIRS M
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061009 INVOKE NUMBE 120172
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P.O. Box 19635 BY. I VOICE DAT
Indianapol Indiana 46219 07/02/09
(317) 322 -5800 PAGE 1
SOLD TO CARMEL CLAY PARKS &c REC. dba. M(" CTR SHIP TO MONON CENTER
114 E. 1161H STREET 1235 CENTRAL PARK DRIVE EAST
CARPEL, IN 46032 CARMEL, IN 46032
(317) 571 -4140
CUSTOMER I.D.: 113422
SHIP VIA: SERVICE P.O. NUMBER:
SHIP DATE: 07/01/09 P.O. DATE:
DUE DATE: OUR ORDER NO:
TERMS: Net 15 SALESMAN: D Ve Beck
PRODUCT I.D. DESCRIPTION ORDERED SHIPPED U/M UNIT P
K RICE AMOUNT TX
7071138636 HOSE TRANSFER RED 5 5 6.50 32.50
7071158000A PETRO GEL 1 1 4.62 4.62
7071111875 SEAL SHAFT ASSY 2 2 13.70 27.40
7071118897 KIT, "O" RING,30&88 T MiT 1 1 104.08 104 -08
1 -5 HOURS 1._500 1.500 65.00 97.50
TRIP CHARGE 45.00
Invoi e subtotal 311.10
Sales 7.000% t
Ins Dice total
SIGNATURE:
1 AGREE THAT EVERYTHING LIED ON INVOICE ISA GCOUNTED FOR 8: UNDAMA GE O, UNLESS OTHE RWISE NOTED.
Pules
P.O. Poi F
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WHITE COPY SOUTHERN FOOD SYSTEMS YELLOW COPY CUSTOMER
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.
362955 Southern Food Systems Terms
P.O. Box 19635
n
Indianapolis, IN 46219
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
7/2/09 120172 Repair soft serve machine 22217 F 311.10
Total 311.10
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.
362955 Southern Food Systems Allowed 20
P.O. Box 19635
Indianapolis, IN 46219
In Sum of
311.10
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #1TITLE AMOUNT Board Members
Dept
1047 120172 4350000 311.10 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
30 -Jul 2009
Signature
311.10 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund