190942 10/13/2010 CITY OF CARMEL, INDIANA VENDOR: 362001 Page 1 of 1
ONE CIVIC SQUARE RUSSELL FARMS
CHECK AMOUNT: $500.00
CARMEL, INDIANA 46032 12290E 191ST ST
NOBLESVILLE IN 46060 CHECK NUMBER: 190942
CHECK DATE: 10/13/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343007 1 500.00 FIELD TRIPS
CaFM Clay
Parks &Recreation CHECK REQUEST
Date I 1
Check payable to
Name: �jS k �&Y r�S
Address: 12Z°1() C. Ills+
City, State, Zip NA S ✓illE IN goo
Mail check to payee Return check to requestor
Check Amount FLU �a Date Requ(red
Check needed for �)V &k
To be paid from
PO (if applicable) 9,160 0 04 0 1 09 PO O a 39�SS
Budget account GL 1O$I �e� y�)q O' 0o
Budget Line Description School Uv+ G -mp Fiet�l �r i�
Supporting documentation or receipt(s) MUST be attached.
Requested by (print): DU\24 -t S -w
Requested by (signature): IVQ 4
i r
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Approved by (signature of Division Manager):
on this date
Form revised 1 -21 -08
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Purch
7
Russell Farms Pumpkin Patch LLC i 4 No. 1
12290 E. 191st. Street
Noblesville, IN 46060
4 INVOICE
Customer
Name Carmel Clay Parks Date 101112010
Address Order No. 1
City State ZIP Rep
Phone FOB
Qty Description Unit Price TOTAL
100 Admission to Russell Farms Pumpkin Patch $5.00 $500.00
on October 21, 2010
Q
a 6 2010
�Y....�.����.......
SubTotai $500.00
Payment Details $0.00
0
0
0 TOTAL $500.00
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.
362001 Russell Farms Pumpkin Patch, LLC Terms
12290 E 191 st Street
Noblesville, IN 46060
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
10/1110 1 Field trip 10/21/10 23988 500.00
Total 500.00
1 hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and 1 have audited same in accordance
with IC 5- 11- 10 -1.6
20_
Clerk- Treasurer
Voucher No. Warrant No.
362001 Russell Farms Pumpkin Patch, LLC Allowed 20
12290 E 191st Street
Noblesville, IN 46060
In Sum of
500.00
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #MTLE AMOUNT Board Members
Dept
1081 -99 1 4343007 500.00 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
7 -Oct 2010
Signature
500.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund