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210951 07/17/2012 CITY OF CARMEL, INDIANA VENDOR: 366315 Page 1 of 1 ONE CIVIC SQUARE MELROSE PYROTECHNICS INC i CARMEL, INDIANA 46032 1 KINGSBURY INDUSTRIAL PARK CHECK AMOUNT: $25,000.00 PO BOX 302 CHECK NUMBER: 210951 KINGSBURG IN 46345 CHECK DATE: 7/17/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1203 4359003 15383 25, 000 . 00 FESTIVAL/COMMUNITY EV a 0 Invoice ° Date: July 4,2012 so Invoice#: 15383 Melrose Pyrotechnics, Inc Terms: net 30 To: City of Carmel One Civic Square Carmel, Indiana 46032 Attn: Nancy Heck, Director of Community Relations 1.00 Ijuly 4th fireworks display a 25,000.00 ' 25,000.00 Project Name: Carmel Fest July 4th display Invoice No: 15383 ; PO No. X26406 i Pte • Subtotal 0 $ 25,000.00 ! Sales Taxi _ Total( $ 25,000.00 Make all checks payable to Melrose Pyrotechnics,Inc. Thank you for your business! P.O.Box 302,1 Kingsbury Industrial Park,Kingsbury,IN 46345;PH 219-393-5522;Fax 219-393-5710 VOUCHER NO. WARRANT NO. ALLOWED 20 Melrose Pyrotechnics, Inc. IN SUM OF $ P. O. Box 302, 1 Kingsbury Industrial Park Kingsbury, IN 46345 $25,000.00 ON ACCOUNT OF APPROPRIATION FOR Community Relations PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 26402 15383 43-590.03 $25,000.00 I 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 Friday, July 13, 2012 cct� dj- Community Relations Title p Cost distribution ledger classification if D claim paid motor vehicle highway fund Prescribed by State Board of Accounts City Form No.201(Rev.1995) ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice or 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. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 07/04/12 15383 $25,000.00 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