180084 12/08/2009 CITY OF CARMEL, INDIANA VENDOR: 362202 Page 1 of 1
Q� ONE CIVIC SQUARE GOODRICH QUALITY THEATRES INC CHECK AMOUNT: $662.25
*4 CARMEL, INDIANA 46032 4417 BROADMOOR
GRAND RAPIDS MI 49512 CHECK NUMBER: 180084
CHECK DATE: 12/8/2009
DEPARTMENT ACCOUNT P O NUMBER INVOICE NUMBER AMOUNT DESCRI
1046 4343007 292 662.25 FIELD TRIPS
i J
Carmel O Clay CHECK REQUEST
Parks &Recreation
Date: 10/19/09
Check payable to
Name: Goodrich Quali Theaters Inc
Address: 4412 BROADMOOR
City, State, Zip Grand Ra ids MI 49512
Mail check to payee j:: Return= check- to- requestor�
Check Amount: $662.25
Date Required 12/18/09
Check needed for: Hamilton 16 Movie Theatre "The Princess and the Fr
Supporting documentation or receipt(s) MUST be attached.
To be paid from
PO
Budget account GL 4341985
Budget Line Description Vendor IMAX Theatre
Requested by (print): Valeska Simmonds
Requested by (signature):
Approved by (signature of Division Manager):
on this date 1���
Form revised 1 -21 -08
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.
362202 Goodrich Quality Theatres Inc. Terms
r 4417 Broadmoor
r
Grand Rapids, MI 49512
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
10/13/09 292 Field trip 12/18/09 FD 22798 662.25
Total 662.25
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.
362202 Goodrich Quality Theatres Inc. Allowed 20
4417 Broadmoor
Grand Rapids, MI 49512
In Sum of
662.25
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1046 292 4343007 662.25 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
3 -Dec 2009
Signature
662.25 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund