257749 04/26/16 a`% fop CITY OF CARMEL, INDIANA VENDOR: 370550
s® ONE CIVIC SQUARE BREAKOUT INDIANAPOLIS CHECK AMOUNT: $*******198.00*
CARMEL, INDIANA 46032 8455 CASTLEWOOD DR CHECK NUMBER: 257749
ay,TeN�` SUITE A CHECK DATE: 04/26/16
INDIANAPOLIS IN 46250
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4239039 000005 198.00 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.
Terms
Breakout Indianapolis
8455 Castlewood Dr, Suite A
Indianapolis, IN 46250
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
3/28/16 5 Staff Training xx3622 $ 198.00
Total $ 198.00
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.
Allowed 20
Breakout Indianapolis
8455 Castlewood Dr, Suite A
Indianapolis, IN 46250 In Sum of$
$ 198.00
I
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
I
PO#or INVOICE NO. CCT#/TITL AMOUNT Board Members
Dept#
1081-2 5 4239039 $ 198.00 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
April 21, 2016
'PAhL0wYUAj
Signature
$ 198.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
Breakout Indianapolis RECEIVED
Info Cannel Clay P&R APR 2_.0 2016
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BY.
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We appreciate your business!Have a wonderful day and enjoy
your game) ith us!_..
Breakout Game(Weekday)x 9 5198.00
Subtotal $198.00
........................_.._......_... ........... ............... .....__._.._._...
Total
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