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306949 01/12/17 w 4�� VENDOR: 370550 CHECK AMOUNT: $*******175.00* �i"��e4 CITY OF CARMEL, INDIA BREAKOUT INDIANAPOLIS CHECK NUMBER: 306949 ONE CIVIC QUARE 8455 CASTLEWOOD DR CHECK DATE: 01/12/17 CARMEL, INDIANA 46032 SUITE A s` �+° INDIANAPOLIS IN 46250 KToii' - DESCRIPTION AMOUNT DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER 175.00 GENERAL PROGRAM SUPPL 1081 4239039 42 \ « o � q \ 00 2 0 / -S & - R z 0 2 > 0 \ 0 ca kCD # CL k° U k # & m w 2 0 2 2 z CD 0 2 ( £_ 9Go 7 7 % CL % > o ■ CD \ -4 CO) -P6k - J ° R q 0 5n q 3 § § CO3 / T g S @ ® - / Er / % % & ( 2 0 > 4 ) d z 0 C) m C) ] 9 - D o m _ \ ° - ƒ§ i ƒ <m _ f2 ° ® . ]E CL Ek o_k / / Q ] 2 ( 9 2 § m Q m ■ E E » � � E m 2 $ % 8 cn § m E EcoM N 2 E 0 _ } CL-CD w / c o E m § g o —4 CL CD M - / C o q �_ 0) & % � CL o � 7 § � 0 Carmel G Clay p rks&Recreafi n CHECK REQUEST Da 1AI r. Chuck a able In BY:............................. Na rne: Address: City, State, Zip Mail the k to payee �Retum check to requestor it C eck Amount: $ ( S Date Required: 2� heck needed for: o be paid from. 0# iiapplicable) I (v( ( � Budget account-GL# Budget Line Description'' upporting documentation or receipt(s)MUST be attached. Requested by (print). Requested by (signature : Approved by(signature of Divis on Manager): `�•.�- on this date Form revised 1-21-06 i Mea an Storms From: Breakout Indianapolis <invoicing@messaging.squareup.com> ' Sent: Wednesday, J nuary 04, 2017 1:30 PM JAN 0 9 ltJ 11 To: Meagan Stor Subject: New Invoice:#1000042 from Breakout Indianapolis BY: 7 x Breakout Indianapolis New Invoice $175.00 due on Jan 26, 2017 Pay Invoice Carmel Clai Parks & Recreation Invoice #000042 January 4, 2017 Customer Meagan Storms mstorms@catmelclayparks.com We appreciate your business. Invoice Sent: /4/17 Game Date: /26/17 Exemption Nt,mber: 0119683083...LOC#001 i I� Corporate Booking -Meagan Storms $175.00 Note: tax exe pt Sub-Total $175.00 Total Due $175.00 Breakout Indianapolis 8455 Ca tlewood Dr , Suite A, Indianapolis, IN 46250 info@breakoutindianapolis.com 317-672-6060 ©2017 Square, Inc. Security Privacy II III 2