252658 12/15/15 ��p"F. CITY OF CARMEL, INDIANA VENDOR: 354772
® ONE CIVIC SQUARE JAMES R HAWKINS CHECK AMOUNT: $ ....`150.00'
CARMEL, INDIANA 46032 12442 HEATHERSTONE PLACE CHECK NUMBER: 252658
�M��ON�d CARMEL IN 46033 CHECK DATE: 12/15/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1192 4343004 150.00 TRAVEL PER DIEMS
Pg 2
2015
Leo Dierckman James Hawkins Dennis Lockwood Earlene Plavchak Alan 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 225 150 150 150 150 75
Tues, Oct 26 X X HO X X Kent Broach
Nov 23 X X X X HO
Claims 150 150 ,/ 150 150 150 ✓ 75
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
i
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
12/10/15 bza per diem-4th qrter $150.00
a
I hereby certify that the attached invoice(s), or bill(s), is(are)true and correct and I have audited same in accordance
with IC 5-11-10-1.6
, 20
Clerk-Treasurer
VOUCHER NO. WARRANT NO.
James R. Hawkins ALLOWED 20
IN SUM OF$
12442 Heatherstone Place
Carmel, IN 46033
$150.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel DOCS
PO#/Dept. INVOICE NO. ACCT#lrITLE AMOUNT
r 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
Friday, December 11, 2015
Director
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund