209250 05/22/2012 CITY OF CARMEL, INDIANA VENDOR: 353512 Page 1 of 1
ONE CIVIC SQUARE MAD SCIENCE OF N CENTRAL IND LLC
CARMEL, INDIANA 46032
6204 LA PAS TRAIL CHECK AMOUNT: $350.00
sa a� INDIANAPOLIS IN 46268 CHECK NUMBER: 209250
CHECK DATE: 5/22/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1082 4340800 1940 350.00 ADULT CONTRACTORS
Mad Science of North Central Indiana Invoice
6204 La Pas Trail Date Invoice
Indianapolis IN, 46268
6/22/2012 1940
Bill To
Carmel Clay Parks and Recreation
1235 Central Park Dr E
Carmel, IN 46032
Attn: Jennifer Hammons
Terms Due Date
Day of Program 6/22/2012
Quantity Description Rate Amount
Mad Science Special Event qty. 1), Creekside 350.00 350.00
Middle School, June 22, 2012, one hour show
Purchase
Description
G.L.
Budget
Line Descr
Purchaser pate y S I
Approval
Thank you for choosing Mad Science -we appreciate your Total
business! $350.00
Payments /Credits $0.00
Balance Due $350.00
Phone
317 388 -0988
V
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Carmel Cla
Parks &Recreatio CHECK REQUEST
Date:
Check payable to 1 r a
Name: 1�1ac\ �G�'0CC OK 1G' c��
Address: A Lcx C' c
City, State, Zip \`f� ��(l S k�1 (0 l(��
Mail check to payee Return check to requestor
2 V
Check Amount 3 �o Date Required fk 0 @0 1 a
Check needed for e `nC\U C C E_kS\ c' c CIA
To be paid from 2 o
PO (if applicable) E ()ocQ�3 Jd D f
Budget account GL 0% o6 on
Budget Line Description
Invoice(s) and Purchase Order (if required) MUST be attached.
Requested by (print): y Q fN c 11��Y�'YZ� S7
Requested by (signature):
Approved by (signature of Division Manager):
on this date
Form revised 7 -7 -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.
353512 Mad Science of North Central Indiana Terms
6204 LaPas Trail
Indianapolis, IN 46268
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
6/22/12 1940 Program Creekside Vac Station 6/22/12 30489 350.00
Total 350.00
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
1 20
Clerk- Treasurer
Voucher No. Warrant No.
353512 Mad Science of North Central Indiana Allowed 20
6204 LaPas Trail
Indianapolis, IN 46268
In Sum of
350.00
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or Board Members
Dept INVOICE NO. ACCT #MTLE AMOUNT
1082 -1 1940 4340800 350.00 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
17 -May 2012
Signature
350.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund