173279 06/10/2009 CITY OF CARMEL, INDIANA VENDOR: 362937 Page 1 of 1
Q�
ONE CIVIC SQUARE COUSINS TENTS AND MORE LLC CHECK AMOUNT: $210.00
+G' CARMEL, INDIANA 46032 5249 NORTH BRANDYWINE
a SHELBYVILLE IN 46176 CHECK NUMBER: 173279
CHECK DATE: 6/10/2009
DEP ARTMENT ACCOUNT PO NU MBER INVOICE NUMBER AMOUNT DESCRIPTION
-f-
1046 4341985 210.00 GUEST SPEAKERS
i
Cousins Tents and More L.L.C.
5244 North Brandywine Road Shelbyville, Indiana 46176
Purchase
P.O
B.,daet
MAY 2 9 2009 a68SW
Purchaser
Approval
13rooketixvood Glelnentary Schaal I Large iV1oollwalk May 29, 3004 12 to i S2IO.Q0
'To to 1 S21 0.00
Tax exempt
Total $21 0.00
Please make ebeelC pagable ta: Cousins Tenft cmd Here
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
5249 North Brandywine Road
Shelbyville, IN 46176
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
5/29/09 05/29/09 Moonwalk at WB 210.00
Total 210.00
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
5249 North Brandywine Road
Shelbyville, IN 46176
l In Sum of
tt
210.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1046 05/29/09 4341985 210.00 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
4 -Jun 2009
Signature
210.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund