212029 08/15/2012 CITY OF CARMEL, INDIANA VENDOR: 365548 Page 1 of 1
ONE CIVIC SQUARE STANDARD COFFEE SERVICE CO
<. t, CHECK AMOUNT: $67.52
CARMEL, INDIANA 46032 PO BOX 952748
ST LOUIS MO 63195-2748 CHECK NUMBER: 212029
CHECK DATE: 8115/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1095 4239040 121986560000 67 . 52 FOOD & BEVERAGES
STANDARD COFFEE SERUICE COMPANY
800-yb2-7006
W61W,COFFEESERUICE.COM
MODIFIED(i)
CUSTOMER ACCOUNT #r 55927 111
CUSTOMER #: 5592789 QICKET #; 121^^x560009
LOCATION # 1191i1,i34 F'O4'
CARMEL CLAY PARKS & RECREAT Dat Om6'2411�;55,51 PM
1195 CENTRAL PARK DR E.,-,_.,. RgUT #5560 T '
CARMEL, IN 96032-0000 I
Lst Pymnt Du Lst Pymnt Amu 0.0
Product Delivered OTY PRICE AMOUNA)
Luzianne Filter Packs 32/3 Oz 1 33.100 33.00
StandaryLl f'6- cei--lee Sugar°...._.1_....... 2_t_38> .31.38
12.22 Oz
Energy Surcharge 1 3,,14 3.14
GOWN—
-
-7777---7777- ""
Subtotal Sale 11p..; - '- A.- 67.52
Sales°iax" J:U�... ._,_._. .........,.._._ "0.00
.. q
0 2016 ----------
DELIUERY TICK T TOTAL 67.52
Previous Acco ence 66,.85
Total Balance Due 134.37
Payments 0.0
ENDINGB,R�LAIICj . �sunmarg e bill m nthly by Invoice
Retain for your records.
Next B3
Mail Payments To;
Standard Coffee Service CO
PO BOX 952798
ST LOUIS, MO 63195-274
Please inclu number
ft�y l
JUL 20 2012
B:
Purchase
Description �il1Ce5'�' .IQY�S
P.O.# I �3, PorF
G.L.# -1—' t� C AL
Budne get
Li Descr �� �� L.
Purchaser Date
Approval Date
�. _ _
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.
365548 Standard Coffee Service Co. Terms
P.O. Box 952748
St. Louis, MO 63195-2748
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
7/16/12 121986560009 Concessions $ 134.37
Total $ 134.37
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.
365548 Standard Coffee Service Co. Allowed 20
P.0 Box 952748; " ss
SLLotais MO.'63195=2748
new address I In Sum of$
$ (p7, S ,,
ON ACCOUNT OF APPROPRIATION FOR
109 - Monon Center
I
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1095-1 121986560009 4239040 $ -x-14-3-7- 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
9-Aug 2012
Signature
$ 134.37 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund