300115 07/12/16 .� "���fr
�;/ � CITY OF CARMEL, INDIANA VENDOR: 54772
;; ® .i ONE CIVIC SQUARE AMES R HAWKINS CHECK AMOUNT: $***'****75.00*
?�; CARMEL, INDIANA 46032 1 442 HEATHERSTONE PLACE CHECK NUMBER: 300115
.,,��TON�, ARMEL IN 46033 CHECK DATE: 07/12/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1192 4343004 062716 75.00 TRAVEL PER DIEMS
VOUCHER NO. WARRANT NO. Prescribed by state Board of Accounts City Form No.201(Rev.1995)
JAMES R HAWKINS ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
12442 HEATHERSTONE PLACE IN SUM OF$ CITY OF CARMEL
An invoice or bill to be properly itemized must show:kind of service,where performed,dates service
CARMEL, IN 46033 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
$75.00 Payee
ON ACCOUNT OF APPROPRIATION FOR Purchase Order#
Dept of Community Service Terms
Date Due
PO# ACCT# DATE INVOICE# DESCRIPTION
DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT
0 43-430.04 $75.00 1 hereby certify that the attached invoice(s),or 6/30/16 0 2nd quarter BZA Per Diem $75.00
1192 6 6 `p n (Cp 101 1192 101
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,July 11,2016
G
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
120—
Cost
20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer
BZA Attendance
2016
Leo Dierckman Jam Hawkins Dennis Lockwood Earlene Plavchak Alan Potasnik Alternates
Jan 25 75 75 75 75 75
Feb 22 75 75 75 75 75
March 5 75 75
March 17 75
March 28 75 75 75 75 75
Claims 375 300 225 225 225
April 25
May 23 75
Anie 27 75 8"aw 75 75 Kent Broach
75
Claims 75 75 0 150 75