185570 05/20/2010 CITY OF CARMEL, INDIANA VENDOR: 237300 Page 1 of 1
ONE CIVIC SQUARE PARTY TIME RENTAL INC
CHECK AMOUNT: $687.75
CARMEL, INDIANA 46032 1015 3RD AVE SW
CARMEL IN 46032
CHECK NUMBER: 185570
CHECK DATE: 5/20/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4353099 168209 687.75 OTHER RENTAL LEASES
The below w by u9
y� Mi.. TY Y eq pment has bean r f U e uncle ned for enLal WrPO;es Dory e d d is understood that PTA InG d1Wa ?art Tane Reel JL I ��r�� 7 C E p {'Lasso }shall oat he held resporb a for arty acddam rr damage r¢suGmg day Indhenry Imo me use al the easatl agmpmani The lass
e t� l p"4'4'J 11 �p eh drsdertns ap wananbes ed} a b� essed a unp Ted rndudmg ary unpSed wd rarNas of: menanWClGy fitness for a perop ar W p i5
and rrefiher assumes wr authonnes ar p other arson u assume fo .rt any kadu y,wnnedGOn wah the use ar th s equlpmeN Tfte lessee agrees_
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EMERGENCY #(317 2523$32 liNp RPRPPNP(8{#4 }382 =5544 �JAIy,ER' ��5;
J,HER£BYAUTHORIZETHE LESSDRTO MAKE 'AP ,ROP llA7, CHARGESTO MY CREOfT I.AAD"
YES INlT1ALSs s Sf Lt& TA
FAILURETOREZURNPROPERTY'{ LEASE) TDI ESSQRWttWN72 R0UR5AFiERAGAEED�MECONSIIMESf 'RU1AfACIE, l3�P094 3 i' j TOTAL
fY@ENCE OF UW -OFUMD CONTROL OVER SAID PROPERTY
HAVE BEEN INSTRUCTED ST 4NFIICFI CAN CONSSIilT1E5 THEFT 7}iEFT IS PtiNISHn'BtE -5 ia`
1' 21 'EARSiNPFtt54NPLUSUP FINE{ EOUIPMEMACNTEOONTFiI SCOf�RIeCTISNOT.FORSME� J r t a b';
rf:g DEMONRATED AN
,THE SAF£'& PROPER,OPERATION OFTFIEf T t ,5
AB0VE E0UIPMENTAND,I FULLY UNDERSTAND, 5 5 SAY 'i1�B 15:'G�i r?Z'
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RieirhGers{ gneilhavrng �BadandundersloadfheatxrvetermsaswellaslheAddtlionaEiCermsandCon�ditionson r r I
#l reverse side tiereol, heFetiy'agrees o the above quipmahVAr is on 1tie,temu and c bons set forth
n the Rental' Agreement; and is "an adtfiorizad agenl'lo� Lessee.,
EOUIPMEN7LEASEDBY
EOUIPMENT.RETURNED BY.X V
Prescribed by State Board ol Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev, 1995)
CITY OF CARMEL
An invoice or 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
Party Time Rental Purchase Order No.
1212 South Rangeline Road Terms
Carmel, IN 46032 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
168 2Q9 payLuent for c for Rolice memoria
Total
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.
1 20
Clerk- Treasurer
VUUUHtH NU. WAHHAN I NU.
ALLOWED 20
P arty Time Rental IN SUM OF
1212 South Rangeline Road
Carm6l, IN 46032
687.75
ON ACCOUNT OF APPROPRIATION FOR
p olice general f und
Board Members
PO# or INVOICE NO. ACCT #!TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
1110 168209 530 -99 687.75 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
May 6 20 10
A,a� -z)l—
Signature
Cbiff
0
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund