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250040 10/06/15 .Cqq �r!� �f� CITY OF CARMEL, INDIANA VENDOR: 369926 `,I. CHECK AMOUNT: $*******200.00* .;; ® ONE CIVIC SQUARE SUSAN K MOWERY 9; ,�: CARMEL, INDIANA 46032 12558 LYNNWOOD BLVD CHECK NUMBER: 250040 '��i iori�°, CARMEL IN 46033 CHECK DATE: 10/06/15 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 854 4359025 200.00 OTHER EXPENSES Non Prafe-�)i bnQ Di W'Si�m 0 0 94 , • CITY`0�`--CEL JAA4Es BRAINARD, MAYOR September 19,2015 Carmel on Canvas Award Winner We would like to congratulate on your recent win-at our Carmel on Canvas event! To receive your award for this event,the City of Carmel does require a W-9 to be on file before a check can be issued.Therefore we will need for you to fill out the attached W-9 form along with including your contact information(name, address,phone number, etc.). Name: 'SkC MV we-7 Mailing Address: L Lh 1,J 17 City, State,Zip: C&-V-L,—R. I Phone Number: 3 7 t © 'N y Email Address: S vtl0we-4 NOTE: Once the City receives this information,they will start the claim's process,which will require City Council approval. The City Council approves claims on the 1St and 3rd Monday of the month for claims that were turned in for the week prior.Therefore the check will not be available immediately and could take a couple of weeks before it is ready.We will mail these checks to you, at the address referenced above, as soon as they are available Congratulations again! City of Carmel Mayor's Office 317-571-2401 INTERNAL USE: Awarded(category/place): ' 5-�- (/U m,-- Art Type(OiUAcrylic/watercolor): PASS Amount of Award: ONE CIVIC SQUARE, CARMEL, IN 46032 PHONE 317.571.240 1, FAx 317.844.3498 EMAIL jbrainard@carmel.in.gov VOUCHER NO. WARRANT NO. ALLOWED 20 Susan Mowery IN SUM OF$ 12558 Lynnwood Boulevard Carmel, IN 46033 $200.00 I ON ACCOUNT OF APPROPRIATION FOR Community Relations Gift Fund 854 i PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 854 Award Letter 1 hereby certify that the attached invoice(s), or I Arts District Festivals $200.00 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 Sunday, September 27,2015 Director, Community Relations/Economic Development 1 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)) 09/19/15 Award Letter $200.00 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