185721 05/26/2010 CITY OF CARMEL, INDIANA VENDOR: 00353387 Page 1 of 1
ONE CIVIC SQUARE FAMILY TIME ENTERTAINMENT, INC CHECK AMOUNT: $125.00
CARMEL, INDIANA 46032 960 E WASHINGTON ST SUITE 1008
INDIANAPOLIS IN 46202 CHECK NUMBER: 185721
CHECK DATE: 5/26/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1082 4340800 3601A 125.00 ADULT CONTRACTORS
�Famil�ime Entertainment, Inc. FED: I D 35- 2135781
960 -E.- Washington Street 317 635 -7770 Main
Suite' 100 B 888- 752 -9109 Toll -free
Ik 1 f Ili 'i'JI' I J'' In anapolis4N 46202 317- 955 -3938 Fax
INVOICE INVOICE DATE
414/_1.0
Purchase FOR CONTRACT
Descriptions 601`
33 P or
P.O. PURCHASE ORDER
Carmel Clay Parks Recreatio%L. 0000000
Jennifer Hammons B; e'iascr��O
1235 Central Park Drive East 5 �ate 1 C�
Purchaser
Carmel IN 46032
DESCRIPTION Location: Orchard Park Elementary School Contract Amt: $125.00
1 Day 617/10 6/7/10 Derek Dye Comedy Juggling Show Deposit Amt: $0.00 Pmt.
Make check to FamilyTime Entertainment
Mail $125 fee to FamilyTime by 06/07/10
Cl$ 125:00
Now Due
Carmel c Cla Parks &Recreation CHECK REQUEST
Date:
Check payable to
Name:
Address V v�l i�v✓1 S vvr�.
City, State, Zip Y1 C51 i G.+IA�CSI Cu �Q cQ
Mail check to payee �Returnheck to requestor
Check Amount Date Required
Check ne J Ak
eded for (y
ee
To be paid from
PQ (if applicable)
Budget account GI_ go(3
Budget Line Description ye nd J
Supporting documentation or receipt(s) MUST be attached.
Requested by (print) C. ,r1 �C�►rY\C
Requested by (signature):
Approved by (signature of Division Manager):
on this date I-io
Form revised 1 -21 -08
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.
00353387 Family Time Entertainment, Inc. Terms
960 E. Washington St., Ste 100 B
Indianapolis, IN 46202
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
4114110 3601A OP Juggling Derek Dye 617/10 23385 125.00
Total 125.00
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.
00353387 Family Time Entertainment, Inc. Allowed 20
960 E. Washington St., Ste 100 B
Indianapolis, IN 46202
In Sum of$
'125.00
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1082 -8 3601A- 4340800 125.00 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
20 -May 2010
'A�'Immv� 2
Signature
125.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund