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174806 07/22/2009 CITY OF CARMEL, INDIANA VENDOR. 362937 Page 1 of 1 ONE CIVIC SQUARE COUSINS TENTS AND MORE LLC CHECK AMOUNT: $2,455.00 CARMEL, INDIANA 46032 9440 NORTH 400 WEST FOUNTAINTOWN IN 46130 CHECK NUMBER: 174806 CHECK DATE: 7122/2009 DEPA RTMENT J AC COUNT PO NUMBE I NVOIC E NUMBER AMOUNT DESCRIPTION 1 1046 4341985 52909001 1,575.00 GUEST SPEAKERS 1046 4341985 70109001 880.00 GUEST SPEAKERS Cousin's Tents and More Daryl Pyle 317 797 5456 Chad Ortel 317 604 -0665 Invoice #L052909001_ for Carmel Clay Parks and Recreation Field Day Event for College Wood Elementary School May 29;2009 t 1 Mobile Rock Wall $500 1 Mobile Game Theater $450 1 Obstacle Course $400 1 Large Moonwalk $150 Labor and Delivery $75 Total: c:-$_1 -5 7.5_ Tax Exempt number: PLwdmo PA* P G.L t Bud et �1 Line v 1 Purchases APPS e JUL U 6 X009 I L J Cousin's Tents and More C�y� Daryl Pyle 317 797 5456,�,,��1 Chad 4rtel 317 604 -0665 Invoice_ 070.10900- 1- f Clay Parks and Recreation Event for College Wood Elementary School West Clay, Cherry Tree and Forest Dale 1 Mobile Rock Wall $800 Delivery $80 Total C$880- Tax Exempt number: JUL 0 6 2009 Purchase Description 7 v P.O. F G.L Budget Line %e Cj1 Purchaser Date(D Approval Date 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. Cousins Tents and More LLC Terms 9440 North 400 West Fountaintown, IN 46130 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO Amount 5129/09 52909001 Inflatables Theatre CW 20880 1,575.00 7/1109 70109001 Rock Wall CW, WC, CT, FD 7/1/09 20907 880.00 7/1/09 Total 2,455.00 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. Cousins Tents and More LLC Allowed 20 ;9440 North 400 West �f= ountalritowriIN 46�13fl �����4 In Sum of 2,455.00 ON ACCOUNT OF APPROPRIATION FOR 104 Program Fund PO# or INVOICE NO. ACCT #/TITL AMOUNT Board Members Dept ept 1046 52909001 4341985 1,575.00 1 hereby certify that the attached invoice(s), or 1046 70109001 4341985 880.00 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 16 -Jul 2009 Signature 2,45550 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund