225466 10/23/2013 CITY OF CARMEL, INDIANA VENDOR: 359483 Page 1 of 1
ONE CIVIC SQUARE MOE'S SOUTHWEST GRILL CHECK AMOUNT: $225.00
CARMEL, INDIANA 46032 12483 N MERIDIAN ST
CARMEL IN 46032 CHECK NUMBER: 225466
CHECK DATE: 10/23/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4239039 100213 225 . 00 GENERAL PROGRAM SUPPL
77 V Z D7
OCT 14 2013
g. 3y:
°" '0..•P '_. .. J fiT. UM V #
TACO Bp-p, (0120a, VT
E 000 37-4 In
Moe's Southwest Grill ► O 8 I -`l— 4
115 5 SR46 Bypass Bloomington, IN 47408 (812) 336-6637
12483 N Meridian Street Carmel, IN 46032 (317) 848-6637
n ree
Item (s): Quantity: ate: Extended Cost:
Taco Bar Special 22 $10.00 1 $220.00
Includes, Pico, Cheese, Lettuce
x rasa .
Items Quantity: ate: Ex—tended 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 $1.001 0 $1.00 1 $0.00
SUB TOTAL: $220.00
Discount $0.00
Customer : Dawn Koepper TAX: $0.00
Date : 10/2/2013 Total: $220.00
Location : Carmel, IN Delivery : $5.00
Total w/delivery $225.00
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.
Terms
359483 Moe's Southwest Grill
12483 N Meridian Street
Carmel, IN 46032
Invoice Invoice Description PO# Amount
Date Number (or note attached invoice(s) or bill(s))
$ 225.00
10/2/13 10/2/13 Taco Bar 10/2/13 PT
Total $ 225.00
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
I
Voucher No. Warrant No.
359483 Moe's Southwest Grill Allowed 20
12483 N Meridian Street
Carmel, IN 46032
In Sum of$
$ 225.00
ON ACCOUNT OF APPROPRIATION FOR
108 - ESE
PO#or Board Members
Dept#
INVOICE NO. ACCT#/TITL AMOUNT
1081-7 10/2/13 4239039 $ 225.00 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
17-Oct 2013
Signature
$ 225.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund