250389 1 0/07/1 5 °�c�qM
;�`` ;'� . CITY OF CARMEL, INDIANA VENDOR: 357681
® I ONE CIVIC SQUARE ALAN POTASNIK CHECK AMOUNT: $"""*525.00`
CARMEL, INDIANA 46032 12482 CHARING CROSS CHECK NUMBER: 250389
"�;,�_ow.�.� CARMEL IN 46033 CHECK DATE: 10/07/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1192 4343004 MEETING 525.00 TRAVEL PER DIEMS
Meeting Dates 7/7/2015 7/21/2015 8/4/2015 8/18/2015 9/1/2015 9/15/2015 Total to
July-Sept Comm PC Comm PC Comm PC Be Paid
Names
Hal Espey- Media Tech no yes no yes no yes
Adams,John W. s $ 75.00 $ 75.00 $ - $ - $ 75.00 $ 75.00 $ 300.00
ti Michael v 7 75.00 75.00 75.00 75.00 450.00
Casa $ 5 00 $ 75.00 $ $ $ $ $
Grabow, Brad $ 75.00 $ 75.00 $ 75.00 $ 75.00 $ 75.00 $ 75.00 $ 450.00
Kestner, Nick $ 75.00 $ 75.00 $ 75.00 $ 75.00 $ 75.00 $ 75.00 $ 450.00
Kirsh,Joshua $ 75.00 $ 75.00 $ 75.00 $ 75.00 $ 75.00 $ 75.00 $ 450.00
Lockwood Dennis 75.00 - 75.00 75.00 75.00 75.00 $ 375.00
Moehl,Tim $ 75.00 $ - $ 75.00 $ 75.00 $ 75.00 $ 75.00 $ 375.00
cP_otasnik-Alan V $ 75.00 $ 75.00 $ - $ 75.00 $ 75.00 $ 75.00 $ X375:00__
Strom uist, Steve `� $ - $ 75.00 $ - $ 75.00 $ - $ - $ 150.00
q
Westermeier, Susan $ 75.00 $ 75.00 $ 75.00 $ 75.00 $ 75.00 $ - $ 375.00
Rider, Kevin yes yes yes yes yes yes
Hollibaugh, Mike yes yes yes yes yes yes $ 3,750.00
Pg 2
2014
Leo Dierckman James Hawkins Dennis Lockwood Earlene Plavchak CAlan_Potasnik- Alternates
July 27 X X X X x
Aug 24 X X X X X Kent Broach
Sept 28 HO No Meeting No Meeting No Meeting No Meeting
Claims 225 150 150 150 `==1"50 = - 75
Tues, Oct 26
Nov 23
Claims
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))
10/05/15 $375.00
10/06/15 $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
VOUCHER NO. WARRANT NO.
ALLOWED 20
Alan Potasnik
IN SUM OF $
12482 Charing Cross Road
Carmel, IN 46033
$525.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel DOCS
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1192 43-430.04 $375.00 I hereby certify that the attached invoice(s), or
bill(s) is(are)true and correct and that the
1192 43-430.04 $150.00
materials or services itemized thereon for
which charge is made were ordered and
received except
Monday, Octo r 05, 2015
Director
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund