209495 06/05/2012 CITY OF CARMEL, INDIANA VENDOR: 365313 Page 1 of 1
ONE CIVIC SQUARE BLU MOON CAFE
CARMEL, INDIANA 46032 200 S RANGELINE RD CHECK AMOUNT: $62.00
SUITE 115 CHECK NUMBER: 209495
CARMEL IN 46032
CHECK DATE: 6/5/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1160 4355100 530121 62.00 PROMOTIONAL FUNDS
Blu Moon Cafe Invoice No. 530121
200 S. Rangeline Rd Ste. 115
Carmel, IN 46032
317- 844 -8310
INVOI
Customer Misc
Name Sharon Kibbe Date 5/30/2012
Address Order No.
City Carmel State IN Zip 46032
Phone (317)251 -7368
Qty D escription Unit Price TOTAL
6 Custom 1/2 Sandwich lunch 9.50 57.00
u n ch
b "P Cot a ,1 L
oZ01�
SubTotal 57.00
Set Up 0% 5.00
Payment Tax Rate(s) 0.00%
i
Comments
TOTAL 62.00
Please make check payable to Blu Moon Caf6
Thank you for your business!
VOUCHER NO. WARRANT NO.
ALLOWED 20
Blu Moon Cafe
IN SUM OF
200 S. Rangeline Road, Suite 115
Carmel, IN 46032
$62.00
ON ACCOUNT OF APPROPRIATION FOR
Mayor's Office
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1160 530121 43- 551.00 $62.00 I 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
nday, June 04, 2012
r
Mayor
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
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
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
05/30/12 530121 $62.00
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