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216466 01/15/2013 "� \4f CITY OF CARMEL, INDIANA VENDOR: 360623 Page 1 of 1 '• ONE CIVIC SQUARE PAPA JOHN'S PIZZA CARMEL, INDIANA 46032 DEPT 771108 CHECK AMOUNT: $30.05 s� 1108 SOLUTIONS CENTER CHECK NUMBER: 216466 CHICAGO IL 60677-1001 CHECK DATE: 1115/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1096 4239039 S1485121024 30 . 05 GENERAL PROGRAM SUPPL 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 S1485121024 Pizza TNO Program $ 30.05 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 $ 30.05 1 20_ Voucher No. Warrant No. 360623 Papa Johns International Allowed 20 Dept771108 1108 Solutions Center Chicago, IL 60677-1001 In Sum of$ $ 30.05 ON ACCOUNT OF APPROPRIATION FOR 109 Monon Center PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members Dept# 1096-70 S1485121024 4239039 $ 30.05 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 10-Jan 2013 Signature $ 30.05 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund