223578 08/27/2013 CITY OF CARMEL, INDIANA VENDOR: 359483 Page 1 of 1
ONE CIVIC SQUARE MOFS SOUTHWEST GRILL
CARMEL, INDIANA 46032 8235 EAST 116TH ST,SUITE 201 CHECK AMOUNT: $1,587.50
'+ + FISHERS IN 46038
CHECK NUMBER: 223578
CHECK DATE: 8/27/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4239039 8/13/13 645 . 00 GENERAL PROGRAM SUPPL
1081 4239039 8/7/13 942 . 50 GENERAL PROGRAM SUPPL
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AUG 3 .7 30129 F
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Moe's Southwest Grill
115 5 SR46 Bypass Bloomington, IN 47408 (812) 336-6637
12483 N Meridian Street Carmel, IN 46032 (317) 848-6637
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Item (s): Quantity: ate: xten e _ ost:
Burrito Boxes 125 $7.50 $937.50
Includes, Pico, Cheese, Lettuce
Items Quantity: ate: --E3ff—endecl Cost:
Guacamole 0 $1.00 $0.00
Sour Cream 0 $0.50 $0.00
Rice 0 $0.50 $0.00
Queso 0 $3.00 $0.00
Drinks 0 $3.00 $0.00
3 cookies for $1.00 0 $1.00 $0.00
SUB TOTAL: $937.50
Discount $0.00
Customer : Dawn/Carmel Clay Parks TAX: $0.00
Date : 8/7/2013 Total: $937.50
Location : Carmel, IN Delivery : $5.00
Total w/delivery $942.50
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Moe's Southwest Grill
115 5 SR46 Bypass Bloomington, IN 47408 (812) 336-6637
12483 N Meridian Street Carmel, IN 46032 (317) 848-6637
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Item (s): Quantity: ate: Extended Cost:
Taco Bar Specialli 80 $8.00 1 $640.00
Includes, Pico, Cheese, Lettuce
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Item (s); Quantity: ate: Extended Cost:
Guacamole 0 $1.00 $0.00
Sour Cream 0 $0.50 $0.00
Rice 0 $0.50 $0.00
— -Queso 0 $3.00 $0-.00-- - .__ -
Drinks 0 $3.00 $0.00
3 cookies for $1.00 0 1 $1.00 $0.00
SUB TOTAL: $640.00
Discount $0.00
Customer : Dawn/Carmel Clay Parks TAX: $0.00
Date : 8/13/2013 Total: $640.00
Location : Carmel, IN Delivery : $5.00
Total w/delivery $645.00
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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.
359483 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
8/7/13 8/7/13 ESE staff training 8/7/13 30129 $ 942.50
8/13/13 8/13/13 Supplies FD 30142 $ 645.00
Total $ 1,587.50
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.
359483 Moe's Southwest Grill Allowed 20
12483 N Meridian Street
Carmel, IN 46032
In Sum of$
$ 1,587.50
ON ACCOUNT OF APPROPRIATION FOR
108 - ESE
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1081-99 8/7/13 4239039 $ 942.50 1 hereby certify that the attached invoice(s), or
1081-4 8/13/13 4239039 $ 645.00 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
22-Aug 2013
Signature
$ 1,587.50 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund