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178732 10/28/2009 CITY OF CARMEL, INDIANA VENDOR: 363346 Page 1 of 1 ONE CIVIC SQUARE INDY BALLOONS.COM CHECK AMOUNT: $555.00 CARMEL, INDIANA 46032 PO BOX 90021 INDIANAPOLIS IN 46240 CHECK NUMBER: 178732 CHECK DATE: 10/28/2009 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1047 4239039 9/8/09 SSS.00 GENERAL PROGRAM SUPPL ue Ilvery Cate Su ��M� T W Th° F Sa f Delivery Time' S Event TlmeF k gig._ Client has been advised of °balloon floating times p Client haseen advised of payment policies` x a Anaiict -on gift item is part of�this order 1111# 'f8>l!t�11CkrI► Ci�ent ,Ars9e� ETa Rec�pYent Compsnp Deliver To O "'�ONOu 1 1fft� BdhngAddress,` DetiveryAddress Cdy State "Zi D State Zip a Phuna Cell Cross Street Neightmrhood Fax t mail ?hone q Spe Handling a tilor Delivery Instruction a �r s vd Sdgnatura(s) [ndyWoo nstakes pnde m dehvenn quahty balloon products We cannot grantee roduets a$et,deh adverse weather conditiows Qty' item Descnptton Hate `Amatirif' t -1 D s Y Y F r Drder I P s 1:.�R eu J �J pel vg T png FORMS OF PAYMENT (select.one� Bub 7c tat x 1. Credit Card Vsa MC Amex Disc Derive Exp_�� Set Up /Stoke or Blll g Pee...- REMITTANCE care I Billing,ZpCode Security -Code y t ame o Card Pre TaxTotal Total Dues 2. Belli Account $35:00 sennce IN Tart AP DepoSrt "'CHECK DUE UPON, DELIVERY' LSub TbtaL 3. Check 14 Prior 'to Delivery SI; Del ?silvered sy: �}ettvenl. Tune Accepted By To #a(Rl3ue Bal Paid w B 1 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. Indy Balloons Terms P.O. Box 90021 Indianapolis, IN 46240 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO Amount 9/12/09 9/8/09 Balloons for Tour de Carmel 22729 F 555.00 Total 555.00 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. Indy Balloons Allowed 20 P.O. Box 90021 Indianapolis, IN 46240 In Sum of 555.00 ON ACCOUNT OF APPROPRIATION FOR 104 Program Fund PO# or Board Members Dept ept INVOICE NO. ACCT #/TITLE AMOUNT 1047 9/8/09 4239039 555.00 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 -Oct 2009 Signature 555.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund