HomeMy WebLinkAbout250639 10/21/15 '-
4'`�..__'*F CITY OF CARMEL, INDIANA VENDOR: 365306
CHECK AMOUNT: $ 96.00'
ONE CIVIC SQUARE DAVE& BUSTERS �"`"""�`
:. ?Q CARMEL, INDIANA 46032 8350 CASTLETON CORNER CHECK NUMBER: 250639
•.y,,;ON, ` INDIANAPOLIS IN 46250 CHECK DATE: 10/21115
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4239039 17159 96.00 GENERAL PROGRAM SUPPL
4Q,i..gj:g,the DocumentK;-� Page ] of 2
ui- G 241 2011
Carmel Clay Parks Event- Power Cards Only 37359.doc r�
to Signing Instructions --
Review Contact:Onwn Koepper
Review document. Booking: Carmel Clay Parks Event-Power
Dave & Buster's Cards Only
Sign 8050 Castleton Corner Dr Owner: Joni Abernathy
Indianapolis IN 46250 Event Date: F(ida_d, 110612015
Sign Ipfen ) r672.2711E t Booking Control: a0Ed00000121E5ZEAU
Page
Invoice#: 17159
Submit
Finish and submit at the 7 1
bottom. l
INVOICE
Account: Carmel Clay Parks&Recreation Sales Person: Jeni Abernathy
Contact: Dawn Koepper Sales Person 317.572.2722
Telephone:
Address:
Phone: (317)573.4026
Fax:
Email: dkoepper@)carmelclaypaiks.com
SUMMARY OF CHARGES
Subtotal
other Items
R Power G+:ds Aclrvatiun Fee $7.110 pts smsx)
S Power Cards y$10.00 pcs skewo
Subtotal Other:$96.00
Subtotal:$96.03
Less Deposits:$0.00
Balance Dur.:�46.nti
Payment is due upon receipt.
If sending payment by company check,please send the check to the following address:
8350 Castleton Corner Dr
Indianapolis,IN 46250
Attn:Special Events
_. -t' -- .._..... ---- -.. _..- -- __-------------- -.... - -
! -I t 4—+ a, r a 'roctK do�]Pns�S,�a`Antact your Sa es epresentafwe.
submit H� I am aapti�Aobr��-s�'gn�tT?eln)rli�n �,'Submit Electronically
have read the Consumer Disclosure
Thank You for choosing Dave& Buster's, Inc.
le,�r�d�►�
ne e-cl cy)
(Type Name)
dkoepper@carmelclayparks.com
https://www.sertifi.com/daveandbusters/sigiiable v4.as a?re uestid=.A AiE01ni... 8/20\/2015`"`rt
p b _ p 9 Q
Carmel • Clay
Parks&Recreation CHECK REQUEST
Date: O ) I J �� OCT 13 2015
sY:_________—
Check payable to:
n I �
Name: (�t P �- 1 ��.(� _
1 2�
Address: ;� ) Co S-� C'. 71/) ��� c C �rJ�
City,State,Zip :T Yl i cA ,-i(- I AJ
Mail check to payee Return check to requestor
Check Amount:$ (0 Date Required: (tl
Purpose of Check: ) o . V ) C �:�j
a 1 r
Supporting documentation or invoice(s)MUST be attached. C `
To be paid from:
PO#(if applicable) R .�
Budget account-GL#
Budget Line Description _IAC Cc �V-1C ��U�') ✓� I�� O`rJl r�ii IM )tet �ci� � � C S
V
Requested by(print):�Ir? r /a
Requested by(signature/date):
Approved by(print): a-Kk
Approved by(signature/date)
Form recreated 3/10/15(Business Services)
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.
365306 Dave & Busters Terms
8350 Castleton Corner Dr
Indianapolis, IN 46250
Invoice Invoice Description
Date Number (or note attached invoices)or bill(s)) PO# Amount
1116115 17159 Inclusion Event 11/6/15 xx2642 $ 96.00
Total $ 96.00
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
120
Clerk-Treasurer
Voucher No, Warrant No.
365306 Dave & Busters Allowed 20
8350 Castleton Corner Dr
Indianapolis, IN 46250
In Sum of$
$ 96.00
ON ACCOUNT OF APPROPRIATION FOR
109 - Monon Center
PO#or Board Members
Dept# INVOICE NO. CCT#/TITL AMOUNT
1096-70 17159 4239039 $ 96.00 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
October 13, 2015
Signature
$ 96.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
i