242343 2 /17/2015 0+fir.t4q*
CITY OF CARMEL, INDIANA VENDOR: 369114
b ONE CIVIC SQUARE WINSTON LONG CHECK AMOUNT: $****...525.00*
. ? CARMEL, INDIANA 46032 12316 BROOKSHIRE PKWY CHECK NUMBER: 242343
-Mt aH-o, CARMEL IN 46033 CHECK DATE: 02/17/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1203 4343004 AFFIDAVIT 450.00 TRAVEL PER DIEMS
1203 4343004 LETTER 75.00 TRAVEL PER DIEMS
Carmet Cabre aub Ederommuuiratiou!5 Commioiou
One Cibic fiquare - Carmel, T,0 46032
February 10, 2015
Ms.Nancy Heck, Director
Dept. of Community Relations & Economic Development
City of Carmel
One Civic Square
Carmel, IN 46032
Dear Nancy:
The following Commission members attended the Carmel Cable & Telecommunications
Commission regularly scheduled meeting on Tuesday, February 10, 2015, and are entitled to a
payment of stipends in the amount of$75.00 each in accordance with Ordinance D-2185-14, as
Amended:
Commission Member Stipends
Christi Cloud $75.00
James D. Garretson $75.00
Joseph C. Griffiths $75.00
Winston Long $75.00
Jeff Worrell $75.00
Very truly yours,
Sharon M. Kibbe
Recording Secretary
Copy: Winston Long, President
STATE OF INDIANA )
) SS:
COUNTY OF HAMILTON )
Affidavit for Payment of Stipends
The undersigned, being duly sworn upon his/her oath, depose and says that he/she
is a duly appointed and acting member of the Cable and Telecommunications
Commission for the City of Carmel, Indiana, and that this Affidavit is submitted for the
purpose of identifying those Commission meetings that the undersigned personally
attended between November 13, 2012 and November 13, 2014, and to request the
payment of stipends from the City of Carmel to the undersigned in accordance with
Ordinances D-2046-11, D-2104-12, D-2150-13, as Amended.
Commission Meetings Attended Stipends
February 12, 2013 $75.00
November 19, 2013 $75.00
February 13, 2014 $75.00
June 10, 2014 $75.00
August 12, 2014 $75.00
November 13, 2014 __ $75.00
' Total $450.00
Winston Long
Subscribed and sworn to before me, a Notary Public, in and for said County, this {o+S-
day of 'Fon'rumnA 2015 .
commission expires:
ffixil !—A 9 Printed: ,Notary Public
Residing in County, Indiana
Prescribed by State Board of Accounts City Form No.201 (Rev.1995)
ACCOUNTS PAYABLE VOUCHER
t
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))
02/10/15 Letter $75.00
02/10/15 Affidavit $450.00
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
120
'� Clerk-Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
Winston Long
IN SUM OF $
12316 Brookshire Parkway
Carmel, IN 46033
$525.00
ON ACCOUNT OF APPROPRIATION FOR
Community Relations
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1203 Letter 43-430.04 $75.00
I hereby certify that the attached invoice(s), or
_
bill(s) is (are)true and correct and that the
1203 Affidavit 43-430.04 $450.00
materials or services itemized thereon for
which charge is made were ordered and
received except
Monday, February 16, 2015
6/fao�-
Director, Commudty Relations/Economic Development
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund