175115 07/22/2009 CITY OF CARMEL, INDIANA VENDOR: 354975 Page 1 of 1
ONE CIVIC SQUARE SAFE PASSAGE TRANS SERVICES, INC
CHECK AMOUNT: $12,464.40
1, CARMEL, INDIANA 46032 Po eox aza
WESTFIELD IN 46074
CHECK NUMBER: 175115
CHECK DATE: 7/22/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1046 4343006 2561 12,464.40 BUS TRIPS
i
Carm Clay
Parks &Recreation CHECK REQUEST
Date: 5128109
Check payable to
Name: Safe Passage Transportation Service, Inc.
Address: P.O. Box 828
City, State, Zip Westfield, IN 46074
Mail check to payee XX Return check to requestor
Check Amount 12.464.40 Date Required 7/27/09
Check needed for ESE Summer camp transportation 7/13109 through 7124/09
Supporting documentation or receipt(s) MUST be attached.
To be paid from
PO 20515
Budget account GL 1 046 4343006
Budget Line Description Bus Trips
Requested by (print): Paula Schlemmer
Requested by (signature): 12 ,U n
Approved by (signature of Division Manager):
on this date �lZ�� d`1
Form revised 1 -21 -08
Safe Passage Transportation Service, Inc.
P. O. Box 828
Westfield, IN 46074
Office (31.7) 896 -1398
Fax (317) 896 -1438
Bill To i
Carmel Clay Parks Recreation
1411 E. 116th Street
Carmel, IN 46032
ATTN: Audrey Kostrzewa
Date Invoice
5/27/2009 2561
Serviced Additional Information Hours of Buses Rate Amount
/24/2009 For Basic Transportation Services provided for the Custom 12,464.40 12,464.40
weeks of July 13, 2009 through July 24, 2009, as
per summer camp scheduling provided by Ben
Johnson.
i MAY 27 2009 eJ
B 'y o
Pumhass ecu-np
nescriptfon �>^�[�D►�
P.O.# or r
a.L.. �JfC:�U3 MCC
Bud tie
Line D8.
Purchaser Data
Approval Date
THANK YOU FOR USING SAFE PASSAGE TOTAL $12,464.40
Terms July 27, 2009
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.
354975 Safe Passage Transportation Service, Inc. Terms
P.O. Box 828 Date Due
Westfield, IN 46074
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
5/27/09 2561 ESE Summer camp transportation 7/13/09 7/24/09 20515 12,464.40
Total 12,464.40
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.
354975 Safe Passage Transportation Service, Inc. Allowed 20
P.O. Box 828
Westfield, IN 46074
In Sum of
12,464.40
ON ACCOUNT OF APPROPRIATION FOR
104 Program
PO# or INVOICE NO. kCCT #/TITLE AMOUNT Board Members
Dept
1046 2561 4343006 12,464.40
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
12,464.40 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund