178428 10/14/2009 CITY OF CARMEL, INDIANA VENDOR: 362632 Page 1 of 1
ONE CIVIC SQUARE TREAT AMERICA FOOD SERVICES CHECK AMOUNT: $106.00
CARMEL, INDIANA 46032 8500 SIIAWNEE MISSION PARKWAY
MERRIAM KS 66202 CHECK NUMBER: 178428
CHECK DATE: 1011412009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
;;1110 4239099 640534 106.00 OTHER MTSCELLANOUS
1
INVOICE #640534
ROUTE 604 604
DRIVER 239 FIELD, WILLIAM
10/02/2009 12:12pm
Treat America
9702 East 30th Street
Indianapolis, IN 46229
CUSTOMER 372602
CARMEL POLICE DEPT.
3 Civic Square
Carmel, IN 46032
TERMS: CHARGE
DELIVERED
[PIN] ITEM CC PRICE QTY AMOUNT
[0354] MAXWELL HOUSE MASTER BLEND 42/1.1 86635 42 26.50 4 106.00
TOTAL DELIVERED 4 106.00
TAX EXEMPT
TOTAL DEPOSIT .00
INVOICE TOTAL 106.00
NO PAYMENT RECORDED
"Thank you for your business"
CUSTOMER SIGNATURE:
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.
1
Payee
Treat America Purchase Order No.
9702 Esat 30th Street Terms
Indianapolis, IN 46229 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
10/2/09 640534 payment for coffee
Total
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
VCJJCHER NO, WARRANT NO.
ALLOWED 20
Treat America
IN SUM OF
9702 East 30th Street
Indianapolis, IN 46229
106.00
ON ACCOUNT OF APPROPRIATION FOR
police general furidd
Board Members
PO# or INVOICE NO. ACCT /TITLE AMOUNT
DEPT. hereby certify
I hb rti that the invoice(s), or
f e a nvo l
1110 640534 390 -99 106.00 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
October 7 20 09
Signature
Chi of of Pol i re
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund