215130 12/04/2012 CITY OF CARMEL, INDIANA VENDOR: 360623 Page 1 of 1
t�0 }-1• ONE CIVIC SQUARE PAPA JOHN'S PIZZA
,o CARMEL, INDIANA 46032 DEPT 771108 CHECK AMOUNT: $250.20
1108 SOLUTIONS CENTER CHECK NUMBER: 215130
CHICAGO IL 60677-1001
CHECK DATE: 12/4/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1095 4341993 51 . 02 S1485120999
1095 4341993 99 . 95 S1485121003
1095 4341993 16 . 07 51485121005
1095 4341993 30 . 05 S1485121006
1095 4341993 37 . 04 51485121012
1095 4341993 16 . 07 S1485121014
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.
360623 Papa Johns International Terms
Dept 771108
1108 Solutions Center
Chicago, IL 60677-1001
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
11/3/12 S1485120999 Party pizzas $ 51.02
11/3/12 S1485121003 Party pizzas $ 99.95
11/10/12 S1485121005 Party pizzas $ 16.07
11/10/12 S1485121006 Party pizzas $ 30.05
11/17/12 S1485121014 Party pizzas $ 16.07
11/17/12 S1485121012 Party pizzas $ 37.04
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 TOTAL $ 250.20
, 20
Voucher No. Warrant No.
360623 Papa Johns International Allowed 20
Dept 771108
1108 Solutions Center
Chicago, IL 60677-1001 In Sum of$
$ 250.20
ON ACCOUNT OF APPROPRIATION FOR
109 - Monon Center
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1095-2 S1485120999 4341993 $ 51.02 1 hereby certify that the attached invoice(s), or
1095-2 S1485121003 4341993 $ 99.95 bill(s) is (are)true and correct and that the
1095-2 S1485121005 4341993 $ 16.07 materials or services itemized thereon for
1095-2 S1485121006 4341993 $ 30.05 which charge is made were ordered and
1095-2 S1485121014 4341993 $ 16.07 received except
1095-2 S1485121012 4341993 $ 37.04
29-Nov 2012
Signature
$ 250.20 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund