173545 06/10/2009 gtif CITY OF CARMEL, INDIANA VENDOR: 362955 Page 1 of 1
ONE CIVIC SQUARE SOUTHERN FOOD SYSTEMS CHECK AMOUNT: $306.31
o CARMEL, INDIANA 46032 PO BOX 19635
INDIANAPOLIS IN 46219 CHECK NUMBER: 173545
CHECK DATE: 6/10/2009
D EPARTMENT AC COUN T PO NUMBER INV OICE NUMBER AMOUNT DESCRIPTION
1047 4350000 119342 306.31 EQUIPMENT REPAIRS M
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F.
.a I MA r o zoos
r ole] -1 1LIVO4 BY 11934?
INVOICE NUMBER
P.O. Box 19635 INVOICE DATE 05/18/09
Indianapolis, Indiana 46219
(317) 322 -5800 PAGE 1
SOLD TO
C CLAY PARS Si RECREATION SHIP TO NONCI�T CE9aTFR
114 E. 116TH STREET 11TH COLLEGE
CAMEL, IN 46032 CARPEL, IN 46033
2J. pR' if, t i
(317) 571. -4140
MAY 2 2 2009 t C 113022
SHIP VIA: SERVICE =NUMBER
SHIP DATE: 05/18/09 B P.O. DATE:
DUE DATE: OUR ORDER NO:
TERMS: C. 0. D. SALESMAN: Dav Beek
PRODUCT I.D. -.x�, bESCRIPTION` ORDERED SHIPPED ah U/M UNIT PRICE AMOUNT TX
u
7071196185 NOZZLE SERRA'T'ED 3 3 2.12 6.36
7071118897 )SIT, "O'• RING,30&.88 T F41T 1 1 104.08 104.08
7071158000A PETRO GEL 1 1 4.62, 4.62
2.25 HOM 2.250 2.250 65.00 146.25
TRIP CHARGE 45.00
Invoice subtotal 306.31
Sales 7.000%
Invoice total Z4.
SIGNA RS:
I AGREE THAT EVERYTHING LISTED ON INVOICE IS ACCOUNTED FOR UNDAMA GEC, UNLESS OTHE Rme NOTED.
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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.
Southern Food Systems Terms
P.O. Box 19635
Indianapolis, IN 46219
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
5/18/09 119342 Repair soft serve machine 20966 306.31
Total 306.31
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
1 20
Clerk- Treasurer
Voucher No. Warrant No.
Southern Food Systems Allowed 20
P.O. Box 19635
Indianapolis, IN 46219
In Sum of
306.31
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT WrITLE AMOUNT Board Members
Dept
1047 119342 4350000 306.31 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
306.31 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund