247218 07/15/15 �u .fAgM
/ CITY OF CARMEL, INDIANA VENDOR: 00350721
ONE CIVIC SQUARE LEO DIERCKMAN CHECK AMOUNT: $*!******150.00*
CARMEL, INDIANA 46032 13316 KICKAPOO TRAIL CHECK NUMBER: 247218
CARMEL IN 46033 CHECK DATE: 07/15/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1192 43 3004 150.00 TRAVEL PER DIEMS
I
I
+l -
I
BZA Attendance
2014
l
Leo Dierckman James Hawkins Dennis Lockwood Earlene Plavchak Alan Potasnik Alternates
Tues, Jan 27 A J P P P p
HO
Friday Jan 30 HO
PAID IN 2014
Mon Feb 23 Cxl li Cxl Cxl Cxl Cxl
I
Sat, March 8 A P PAID BY LISA A A
workshop
Mon, Mar 23 P I P P P P
HO
Claims $75.00 $225.00 $150.00 $150.00 $150.00
Apr 27 P P P P P
Tues, May 26 P A P P P Kent Broach
June 22 X X X X HO
Claims $150 $75 $150 $150 $225 $75
'1
ti
i
VOUCHER NO. WARRANT NO.
ALLOWED 20
Leo Dierckman
IN SUM OF$
13316 Kickapoo Trail
Carmel, IN 46033
$150-.00------
ON
150...00 _____ON ACCOUNT OF APPROPRIATION FOR
Carmel DOCS
PO#/Dept. INVOICE NO. I ACCT#/TITLE AMOUNT Board Members
1192 43-430.04 $150.00
I hereby certify that the attached invoice(s), or
I I I
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
0
Friday, July 10, 2015
Director
Title
Cost distribution ledger classification if
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))
07/08/15 $150.00
I 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