171834 04/29/2009 CITY OF CARMEL, INDIANA VENDOR: 00353387 Page 1 of 1
ONE CIVIC SQUARE FAMILY TIME ENTERTAINMENT, INC
CARMEL, INDIANA 46032 960 E WASHINGTON ST SUITE 1008 CHECK AMOUNT: $400.00
INDIANAPOLIS IN 46202 CHECK NUMBER: 171834
CHECK DATE: 4/29/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1046 4340800 3240E 400.00 ADULT CONTRACTORS
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Car Mel c Clad®
Parks &Recreation CHECK REQUEST
Date:
Check payable to APR 0 S 2009
Name:
Address:
City, State, Zip i \A
Mail check to payee Return check to requestor
Check Amount Date Required
Check needed for \_�6\1
To be paid from II��
PO (if applicable) V
Budget account GL S260 6Ai
Budget Line Description NC)
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Supporting documentation or receipt(s) MUST be attached.
Requested b
q y (print Y1
Requested by (signature):
Approved by (signature of 1 Division Manager):
on this date ���I 10 j
Form revised 1 -21 -08
FamilyTime Entertainment, Inc. FED: I D 35-2135781
960 E. Washington Street 317-635-7770 Main 1--
Suite 100 B 888-752-9109 Toll-free MAR 2 7 2009
FAm i axTj m
I h I I. I. Indianapolis IN 46202
INVOICE INVOICE [UiE
3/23/09
FOR CONTRACT
Purchase 3240
Description -ni 11%t%Lj AS E ORDER
P.O. 0 ;I
Carmel Clay Parks Recreation G.L. j LQ 1 D0 qrl Li�k 3
Ben Johnson Valeska Simmons d r' g1vm\ CCr1&N0 (�'(j 3 (N
Elu I
1235 Central Park Drive East E
Carmel IN 46032 Purchaser Date APP, 0 6 2009
Approval o
7CIate
Line t scr 2
BY:
DESCRIPTION Location: Lawrence W Inlo Park Contract Amt: $400.00
1 Day 5/4/09 5/4/09 Don Miller Comedy-Magic Show 2:00 Deposit Amt: $0.00
Pmt.
1 Day 5/4/09 5/4/09 Paul Odenwelder The PIRATES SHOW 3:00
Mail $400 fee to FamilyTime by 05/1/09
Make check to FamilyTime Entertainment $400.00
Now Duel
INDIANA RETAIL TAX EXEMPT PAGE
®I' C �I CERTIFICATE NO. 003120155 002 0
1i Cus 1Lli1d PURCHASE ORDER NUMBER
O ty
FEDERAL EXCISE TAX EXEMPT 190O�
35- 60000972
ONE CIVIC SQUARE EHISN BER MUST APPEAR ON INVOICES, A/P
CARMEL INDIANA 46032 -2584 DELIVERY MEMO, PACKING SLIPS,
LABELS AND ANY CORRESPONDENCE.
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. 'VENDOR NO. DESCRIPTION
,—o chi
VENDOR SHIP APR 0 6 2009
BY:
CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
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Send Invoice To:
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECTACCOUNT AMOUNT
le PAYMENT
U t A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
f'` NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCT I
SHIP REPAID. HEREB TIFYTHATTHERE IS AN UNOBLIGATED BALANCE IN
THIS AIR PRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED.
PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS.
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
202 CLERK TREASURER
DOCUMENT CONTROL NO. VENDOR COPY
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
3/23/09 3240 E Comedy -Magic show 5/4/09 Inlow Park 20289 F 400.00
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Total 400.00
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
400.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #MTLE AMOUNT Board Members
Dept
1046 3240 E 4340800 400.00 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
22 -Apr 2009
1 2
Signature
400.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
9