HomeMy WebLinkAbout197574 05/26/2011 CITY OF CARMEL, INDIANA VENDOR: 359962 Page 1 of 1
ONE CIVIC SQUARE BRADFORD WOODS
CARMEL, INDIANA 46032 5040 STATE ROAD 67N CHECK AMOUNT: $1,037.50
MARTINSVILLE IN 46151 CHECK NUMBER: 197574
T4 i a `�io
CHECK DATE: 512612011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1082 4343007 6/7 1,037.50 FIELD TRIPS
Carmel a Clay
Parks &Recreation CHECK REQUEST
Date: 5 -16 -11
Check payable to
Name: R'W WQC�S
Address: S &A C) Std Nod*
V
City, State, Zip ��C_ U �S
Mail check to payee X Return check to requestor
Check Amount 1 O 5(D Date Required
Check needed for C� o\ o� t V66 wcv
on 6u� 1 LU I
To be paid from
PO (if applicable)
Budget account GL 1082 -9 4343007
Budget Line Description Field Trip
Invoice(s) and Purchase Order (if required) MUST be attached.
Requested by (print): Jennifer Holder
Requested by (signature):�� 0
Approved by (signature of Division j Manager):
on this date Y -1
Form revised 7 -7 -08 Shared Administrative Forms Staff forms Check Request (rev 7 -7 -08)
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iF cviy_ 'fAtSfYGIJCI4.CTip
SERVICE AGREEMENT CONTRACT
TV a Dvanmt W :mead by and I ?Ca':L'C❑ 13rattlotd vVoods on beilai ltaswes of }ndona €JAVe;SA '1 W(fO;iS ;lrifi
Carmcl Clay Pa rks (Grou
PROGRA W Purchase
AL. Da— Ptogmm Description kI l`t
cmaN ch PaW P.O.# Po
Budget b
llieti: €i31'. 3131:;. 07: 0 1 1 -1 i :00 A'` -1 Unn DsaC►
DEPART, Purchaser 2 Date
;',C3 Approv Date f
Br<itlford Woods i11 pivyide to tiil'+Jka1:!, on Me :7wNe Caves, use of the €Cs}lowin ;1 i'L'fe)'1Si:iliEilk:
)';m :€mwd nninhex td paa'tieQant3; to aneud: 25
E:mialaKI number of chaperones to attend 0
I.''.3ti3i7 }tiL'CI s or clia0erunes (reduced) to sttend: a
Estimated tt?tal of participants to attend: 29
tstimawd Loss:
Co—,[I)Lr 11 itidpm1t: 541,50
Cost Per Cl aperollo: S4 L5f0
Coss per C'hdperos >c. (,Kkducedy 50.00
E3iliing Minitnlms: 75% oi' FoW 1'_stimawd Event Cost
Tool. Estivamad Wa Cwt:: (Si.'c O's 13 14 below). 5
TOT• NON- RF:Ft €�N'I)APLL 1)I: POSIT RF- Qt €IRFI) WAIVED
1, C>eaertll;)las7: Pnaent: (;c ^c °at€ ss 1 ;1!n: =3r o:'ta tr,!lcoer cc ?7ii:; urll rcarii 3 ;7i, 13:a E +r l 1t:i.;uv. 1'}se Jirtii33i>;t1 1t i `l i -..,t,
Diecli22 and t ;at pQmo;Q des ynno kiss, amKorily to zt:€ rG3zx w,,;€ 'c ,lla[icr:c, rqts MKg iis, uso A Brad Awd ti''noiF�.
2. ,1sci�ns27eist !3f ;'.nTCCI3letit'.: vWT ,rii: m it Agn the .3 +!rc:° ani Car pawn In nWd we Meows +)r mj Pack 3 7'.• <)1 w�i31;: v P; Fur'.`,dan
pennis ion nfl3: 1i'wxlc
th adbrt! Moody PoUdes and I's'ucelltirct: my liw t': reK4 klt.sli, c. hm i'Ct.Jnd a t 0p) of Bla dfi rd VOWS ]solver a nd ;:t; ?e' ;It: n k€ m
to sp, ila e!� ise. All paflivipr h e bnn s,; R be irai pnec of 14SO poh e :3sd ^r, t,
+jrpUP H r ee: to :::ewe by at PARRY and pit?ce 'sirs ewiitowd }krK. i my aamn Msi.m k 1,ic tw we ;;c;lmi)
S.apctti ";iotr, tikl'C, 33:C€ %kV 1 `c Eda g?nnq; p:.r?l iall•• S <il:C1 !f:j f C'l c S. "o1imtce::S, 11 ?210tc; ti! i tiii EL!rm of t1 i, ii ecnnv.w.
4. 1nVCSt3'11oW Gto..!p s ,•i, W ^.:?j• t Y )k1i•:3.r d Mn& At t[i`SC$ Eur?€i •ICi3Sj:;,li: d SU +t'hTh MYY jM7,Ld•. i`tit r7o; •j5,rdkc;d 9n-
i:i:J317 ti1k 11 €U:i L' 7 ';app €1 ;,"o �G: �'3Gd._ e- �t[l pm WA 3: We:ban. ous US I:;Soy,il y ash me pealw an N:1C,tkmod ho Q7}1.22:
Estimated Event Cost:
F`svrrle! f Via: E7 ilule: 1>'7c��.��r;� ^.c: �r•. s. J •s.�;7trr:..,.: c.;tc ;lz:cvv, J, dl:ai:`; ,l, �.:...:::....•.....x.:,t:
O dS3ils;r..n '3 sl:i we WHO ai }viii s },i;. hand an ?w-3 lma ba of t .7,rim af; avi;::,c 2 'c
d i J i i i i I f 3)v 1'n'v F iz i i ou t:m 11 a':.'! a It. i.� I I d o J. th,
H i '!"I. kv i 7 >of T1 Jo 1
j m"d 11 Ad it 5 :sP
3 313 jklS C'!S. it �;e r" i:. l3 :$31 Ci 1:f.: moo or. v, 4 }3 w :j i o!"JA j)�D o t•; af 1"I i
now1d to Q no of Brasohni IWO. WMAngowma AMA 1.4no"Kno na" kor
orbywy 1v proony nose &M Wo oymb nqmzw�
I An ROW I a we nat to BwMWdMvxk dot WX No q a ,..t..,: L .t M&MUPW SAY W POSAWK WOR ad i havl W VAX W
a Wamoven am PaW Ott Me vqAW amoun bc tomal&. M "yWis, T--�
#iv% J, he ;K ilI "'Vi1 1 1:
1104 stroce PaQ, %Rru MqU4 ::r 5 ans 10N OW W Aw F am ,.17j.
is o'. hWAxVQKWAv W sk"Mm of t to vjWW& WIN yowl WvJ
PMONW. NV POW WwAg W hu"WAV Q .vd v vch c HMO asks ,11. d
my?k johns W IN ;MM;QjWhVJy to ,AV OWAN OMM60d at MR how AH gmTs muA memo to wnivkvA •eski =Qn wkij
5100 "of 110ndc n W o; W Wyesky lot lqui he 0SW WIM01 "awc.
Ji eM.["t' ol tJ favOlt yHy Wmp of pankysw #,-f n
ir, nnt l
ar a rj tkx oi''N ti ro t:lc r vf i 11 'I to no n W A jxM gnu w E foti; toc:'. I.1 -n i al I l ;vik k3 'd
of QT O"T A Q hwok dn""N" c' t waying PnInIvAny. Sol kwo vy AW PAWA AWAM Ito .t} ,J.. ywhx'>
=awa gnq of be imp reqn4alksk T431 EXAMW Evapf QW, R&AWAVA. Awhaux yowl OWWW"A a Vsv.
J.4 Cnn'!eli.kkw Poik!y. Crciijp ave"11 Mo kJowing CA NCEINAIMN smuc V V GMq"WAd MW PN;rnnn
ch"p WHO hdd wPoslsibkl [n 'w`; 6--e33u"i", tJlkw
icy` h 61 dyi BeAv phr ts pmVovi daw- 056 of Wmawd wed WdANan to
tV'ifli.11-60 fk tlffjdcc^, pv[ of to i1rup',1m AM -261 alludinsed Q1 c%i in ad(HUyn to d"Popt
With .30 days t)r vulke prhr to prPerAm dak SM4 of 5141401 AW Wt 5 ndWdan WvpW
Ur i!l-" i"nrn- ..'faks uptsvem "A Bi-
v. it top do& am y nat he good
camd CQY mm's
I
I
IN 40-'.z
of 7 679 qW." Wdy to?
Ws WM NUNN Me WWg a he kpmit and VaI. bawnce thr A JU nanun", yuku
jnoraoed Wo,iso PI"Ac rumplev the lt3thrr3 rlfioil below st tll;tt -'N V. fna: 131 111i,
PF USING FOONDA ION I, PLEASE REMIT CHECK INNECTLY,',
For ThMTnsQes of IndAns WNe"iy:
91.
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.
Bradford Woods Terms
5040 State Road 67 North
Martinsville, IN 46151
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
6/7/11 6/7 Field trip Chillville 6/7/11 1,037.50
Total 1,037.50
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.
Bradford Woods Allowed 20
5040 State Road 67 North
Martinsville, IN 46151
In Sum of
1,037.50
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1082 -9 6/7 4343007 1,037.50 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
19 -May 2011
Signature
1,037.50 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund