250192 10/07/15 Q
CITY OF CARMEL, INDIANA VENDOR: 00350721
ONE CIVIC SQUARE LEO DIERCKMAN CHECK AMOUNT: $**..."225.00'
CARMEL, INDIANA 46032 13316 KICKAP00 TRAIL CHECK NUMBER: 250192
CARMEL IN 46033 CHECK DATE: 10/07/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1192 4343004 225.00 TRAVEL PER DIEMS
Pg 2
2014
(L7X !!ix
awkins Dennis Lockwood Earlene Plavchak Alan Potasnik Alternates
July 27 X X x
Aug 24 X X X Kent Broach
Sept 28 HO No Meeting No Meeting No Meeting No Meeting
Claims C-225-------J 150 150 150 150 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 $225.00
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
20
Clerk-Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
Leo Dierckman
IN SUM OF $
13316 Kickapoo Trail
Carmel, IN 46033
$225.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel DOCS
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1192 43-430.04 $225.00
I hereby certify that the attached invoice(s), or
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
Monday, October 05, 2015
Director
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund