178642 10/28/2009 CITY OF CARMEL, INDIANA VENDOR: 363540 Page 1 of 1
ONE CIVIC SQUARE CAPTAIN BOUNCE, INC CHECK AMOUNT: $3,271.87
CARMEL, INDIANA 46032 707B ARROYO
SAN FERNANDO CA 91340 CHECK NUMBER: 178642
CHECK DATE: 10/28/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1046 4239039 11267 1,635.94 GENERAL PROGRAM SUPPL
1047 4463000 11267 1,635.93 FURNITURE FIXTURES
e
-6j j 'klim Captain Bounce, Inc. Invoice
707 Arroyo Date Invoice
San Fernando, CA 91340 C °X9/24/2009) rrz67
877.393.3638
Bill To Ship To
Carmel Clay Parks Rec Monon Center
t Serra Garske Kate Schneider
1411 E 116th St 1235 Central Park Dr. E
Carmel, IN 46032 Carmel, IN 46032
Terms Rep Ship Via
Due on receipt STEVE 9/24/2009 FREIGHT
Quantity Item Code Description Shipping Info Price Each Amount
1 1028 -15 Module Yellow/Blue 15X15 1,395.00 1,395.00
1 1217 -15 Module Yellow/Red 15x15 1,395.00 1,395.00
SHIPPING Shipping to 46032 481.87 481.87
Purchase
Description
P.O. a rl,�f.is rQ 0-3
G. L, 0 Q i�35,9 OCT
4 2009
u eV
Purchaser 0
ra y..
App a>fe___ 3
ALL UNITS INCLUDEBLOWER(S), STAKES, STRAPS, TARP(S), PATCH KIT, STARTER
Total $3,271.87
PACKAGE AND 2 YEAR WARRANTY (I YEAR ON WATER PRODUCTS). ALL DEPOSITS
RECIEVED ARE NON REFUNDABLE. CUSTOMER IS RESPONSIBLE FOR COST, Payments/Credits $0.00
TRACKING AND FOLLOWING UP ON SHIPMENT. ALL SHIPPING OUOTES ARE
ESTIMATES CAPTAIN BOUNCE, INC. WILL NOT BE RESPONSIBLE FOR INCREASED
SHIPPING COSTS. CAPTAIN BOUNCE, INC. IS NOT RESPONSIBLE FOR TRACKING
FINAL PAYMENT(S), THUS RESPONSIBILITY FALLS ON THE PART OF THE CUSTOMER. Balance Due (—$3,27.1.87_
ALL PURCHASES ARE FINAL, NO RETURNS OR EXCHANGES. PLEASE VISIT
www.CaptainBonnce.com TO REVIEW OUR COMPLETE TERMS AND CONDITIONS.
Web Site www.CaptainBounce.com
Email info @captainbounce.com
L 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.
Captain Bounce, Inc. Terms
707B Arroyo
San Fernando, CA 91340
_F Invoice In Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
9/24/09 11267 Bounce house 22578 F 1,635.94
9/24/09 11267 Bounce house 22578 F 1,635.93
Total 3,271.87
I 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.
Captain Bounce, Inc. Allowed 20
707B Arroyo
San Fernando, CA 91340
In Sum of
3,271.87
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #TTITLE AMOUNT Board Members
Dept
1046 11267 4239039 1,635.94 1 hereby certify that the attached invoice(s), or
1047 11267 4463000 1,635.93 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 -Oct 2009
Signature
3,271.87 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund