223089 08/13/2013 CITY OF CARMEL, INDIANA VENDOR: 359483 Page 1 of 1
ONE CIVIC SQUARE MOE'S SOUTHWEST GRILL
CARMEL, INDIANA 46032 12483 N MERIDIAN ST CHECK AMOUNT: $223.00
CARMEL IN 46032
CHECK NUMBER: 223089
CHECK DATE: 8/13/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1082 4239039 8/1/13 223 . 00 GENERAL PROGRAM SUPPL
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Moe's Southwest Grill
--11-5-5-SR46--Bypass-Bloomington, IN 47408 (812) 336-663-7
12483 N Meridian Street Carmel, IN 46032 (317) 848-6637
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Item (s): Quantity: Rate: Extended Cost:
TACO BAR SPECIAgj 20 $10.00 —T $200.00
Includes, Pico, Cheese, Lettuce
PR
Items : Quantity: Rate: Extended Cost:
Guacamole 0 $1.00 $0.00
Sour Cream 0 $0.50 $0.00
Rice 0 $0.50 $0.00
Drinks 0 $3.00 $0.00
3 cookies for $1.00 0 $1.00 $0.00
SUB TOTAL: $200.00
Discount $0.00
Customer : dawn TAX' T8'OD�
Date : 8/1/2013 Total: $218.00
Location : indianapolis Delivery : $5.00
Total w/delivery $223.00
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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.
Moe's Southwest Grill Terms
12483 N Meridian Street
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO # Amount
8/1/13 8/1/13 Taco bar 8/1/13 Impact $ 223.00
Total $ 223.00
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.
Moe's Southwest Grill Allowed 20
12483 N Meridian Street
Carmel, IN 46032
In Sum of$
$ 223.00
ON ACCOUNT OF APPROPRIATION FOR
108 - ESE
Po#or Board Members
INVOICE NO. ACCT#/TITLE AMOUNT
Dept#
1082-99 8/1/13 4239039 $ 223.00 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
8-Aug 2013
Signature
$ 223.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund