250034 10/06/15 / ,• CITY OF CARMEL, INDIANA VENDOR: 368784
ONE CIVIC SQUARE JEFFREY J KLINKER CHECK AMOUNT: $*******100.00*
i` CARMEL, INDIANA 46032 11835 N US HIGHWAY 231 CHECK NUMBER: 250034
LINDEN IN 47955 CHECK DATE: 10/06/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
854 4359025 100.00 ARTS DISTRICT FESTIVA
T
CIS � ��� � ►]EZMEL
JAMES BRAINARD, MAYOR
September 19,2015
Carmel on Canvas Award Winner
We would like to congratulate on your recent win at our Carmel on Canvas event!
To receive your award for this event,the City of Carmel does require a W-9 to be on file before a
check can be issued.Therefore we will need for you to fill out the attached W-9 form along with
including your contact information(name, address,phone number, etc.).
Name: 2..� -��
Mailing Address: I �Zj S }��/l� 231
City, State,Zip: i n 6-e r)
Phone Number: � -- �l 7,P
Email Address: jjj
0� j 0t h o o . G 0 11A
NOTE: Once the City receives this information,they will start the claim's process,which will
require City Council approval. The City Council approves claims on the 1St and 3rd Monday of the
month for claims that were turned in for the week prior. Therefore the check will not be available
immediately and could take a couple of weeks before it is ready.We will mail these checks to you,
at the address referenced above;as soon as they are available _
Congratulations again!
City of Carmel
Mayor's Office
317-571-2401
INTERNAL USE:
Awarded(category/place): PfD(QS)t-Y A'(/�W?Art Type(Oil/Acrylic/watercolor):
Amount of Award: �1 10-0
ONE CIVIC SQUARE,CARMEL, IN 46032 PHONE 31 7.571.2401, FAx 3 17.844.3498
EMAIL jbrainard@carmel.in.gov
VOUCHER NO. WARRANT NO.
ALLOWED 20
Jeffrey J. Klinker
IN SUM OF$
11835 N. U.S. Highway 231
Linden, IN 47955
$100.00
ON ACCOUNT OF APPROPRIATION FOR
Community Relations Gift Fund 854
PO#/Dept. INVOICE NO. ACCT#!TITLE AMOUNT
Board Members
854 I Award Letter I Arts District Festivals I $100.00 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
I
which charge is made were ordered and
received except
Sunday,September 27,2015
�+ Director,Community Relations/Economic Development
Title
r'
Cost distribution ledger classification if
claim paid motor vehicle highway fund t
ti
t
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 $100.00
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