252756 12/15/15 (9,
CITY OF CARMEL, INDIANA VENDOR: 357681
ONE CIVIC SQUARE ALAN POTASNIK CHECK AMOUNT: $*******600.00*
CARMEL, INDIANA 46032 12482 CHARING CROSS CHECK NUMBER: 252756
CARMEL IN 46033 CHECK DATE: 12/15/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1192 4343004 MEETINGS 600.00 TRAVEL PER DIEMS
Meeting Dates Total to
Oct- Dec Comm Dialogue Plan Comm Plan Comm Plan Be Paid
Names Dinner
Hal Espey- Media Tech no no yes no yes no yes
Adams,John W., $ 75.00 $ - $ 75.00 $ - $ 75.00 $ 75.00 $ 75.00 $ 375.00
Casati, Michael $ 75.00 $ 75.00 $ 75.00 $ - $ 75.00 $ 75.00 $ 75.00 $ 450.00
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 $ 375.00
Lockwood, Dennis $ 75.00 $ 75.00 $ 75.00 $ - $ 75.00 $ 75.00 $ 75.00 $ 450.00
Moehl,Tim ', $ 75.00 $ - $ 75.00 $ - $ 75.00 $ 75.00 $ 75.00 $ 375.00
Potasnik, Alan $ 75.00 $ - $ 75.00 $ 75.00 $ 75.00 $ 75.00 $ 75.00 $ 450.00
Stromquist, Steve $ 75.00 $ - $ 75.00 $ - $ 75.00 $ - $ 75.00 $ 300.00
Westermeier, Susan $ 75.00 $ - $ 75.00 $ 75.00 $ - $ 75.00 $ 75.00 $ 375.00
Rider, Kevin yes no yes yes yes yes yes $ 4,050.00
Hollibaugh, Mike yes yes yes no yes yes yes
City Form No.201 (Rev.1995)
Prescribed by State Board of Accounts
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
Description Amount
Invoice Invoice
Date Number (or note attached invoice(s)or bill(s))
$450.00
12/10/15 4th qrtr PC per diems
$150.00
12/10/15 bza per diems-4th grtr
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. — 20
ALLOWED
Alan Potasnik IN SUM OF $
12482 Charing Cross Road
Carmel, IN 46033
$600.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel DOCS
:Po�#!Dept INVOICE NO. ACCT#(TITLE AMOUNT
Board Members
I hereby certify that the attached invoice(s), or
1192 43-430.04 $450.00
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
Friday, De emb r 11 015
Director
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund