314098 7/26/2017 CITY OF CARMEL, INDIANA VENDOR: 371831
ONE CIVIC SQUARE BREAKOUT, INC. """""""
CHECK AMOUNT: $ 250.00"
Q CARMEL, INDIANA 46032 696 OLD BETHPAGE ROAD CHECK NUMBER: 314098
PO BOX 280 CHECK DATE: 07/26/17
OLD BETHPAGE NY 11804
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1082 4239039 7852 250.00 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 3-1 I d3
Purchase Order No.
Breakout, Inc. Terms
PO Box 280
Old Bethpage, NY 11804
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
7/5/17 7852 Team Building Camp Supplies 41785 $ 250.00
Total Is 250.00
1 hereby certify that the attached invoice(s),or bill(s)is(are)true and correct and I have audited same in accordance
with 1c 5-11-10-1.6
20_
Clerk-Treasurer
Breakout, Inc.
PO Box 280-696 Old Bethpage Rd ���.
Old Bethpage, NY 11804 j'
info@breakoutedu.com J 9 n 11
BreakoutEDU.com
BY: _.._.._-_..._... -—
BILL TO
Carmel Clay Parks&Recreation
1411 E 116th Street
Carmel, IN 46032
Breakout EDU IQ2 125.00 250.00
Re: PO 41785
........ . . _..... ........ . ....................... ................................................ . ....... ......... ................................. ...... .............. ............................................. .........
Re:PO 41785
Direct any inquires about your order to info@breakoutedu.com.
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