HomeMy WebLinkAbout208844 05/10/2012 CITY OF CARMEL, INDIANA VENDOR: 366236 Page 1 of 1
ONE CIVIC SQUARE QDOBA MEXICAN GRILL CHECK AMOUNT: $196.20
tio, ®4�o CARMEL, INDIANA 46032 2328 EAST 116TH STREET
CARMEL IN 46032 CHECK NUMBER: 208844
CHECK DATE: 5/10/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4239039 5/23/12 182.99 GENERAL PROGRAM SUPPL
1081 4340800 5/23/12 13.21 ADULT CONTRACTORS
05 /01/ 012 11:46 FAX 3177336501 WEST CLAY ELEMENTARY 0 002 /003
SOU I
f
Ca rTl e ®C l a Y
C Y Parks Recre ati on CHECK REQUEST
Date:
Check payabl_�
Name: Q) 6C
Address:
Clty, State, Zip Cc,f me—
Mail check to payee Return check to r'iequestor
Check Amount 6 Date Requir
Check needed for VCA
To be paid from U S
PO (if applicable) E 6
Budget account GL# ''Fa 08'1 1 �9 6 9
a oo (cZ
Budget Line Description �or S
Invoice(s) and Purchase Order (If requiree7 MUST be attached.
Requested by (print): V
Requested by (signature):
Approved by (signature of Division Manager): I
on this date H
Form revised 7 -7 -08 Shared Administrative Forms Staff forms Check Request (rev 7 -7 -08)
05/01/2012 11:47 FAX 3177336501 WEST CLAY ELEMENTARY 003/003
INVOICE
Qdaba Mexican Grill DATE; MAY 1, 2012
More to Eviore
2328 EaSE 116th, Carmel, in. 44032
Phone 317-615-9320 Fay 117-815.9347
QrnV028 (&q4oba-Com
TO west Clay Elementary
Carmel., In.
QTy 176M 0 UN IT PRICK AD -0N 1. LINE TOU L
Zp Not Bar Nacho Mr
Purchase
Description
P.O. 0
G.L.
Budget no
Line Descr
D
Purchaser Date—_ J
Approval
Fee
SALES TAX 16.20
TIP
TOTAL I 196.20
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.
Qdoba Mexican Grill Terms
2328 East 116th Street
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
5/1/12 5/23/12 Food for staff Summer Camp WC 182.99
5/1/12 5/23/12 Food for staff Summer Camp CW 13.21
Total 196.20
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.
Qdoba Mexican Grill Allowed 20
2328 East 116th Street
Carmel, IN 46032
In Sum of
196.20
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1081 -10 5/23/12 4239039 182.99 1 hereby certify that the attached invoice(s), or
1081 -3 5/23/12 4340800 13.21 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
3 -May 2012
Signature
196.20 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund