304029 10/10/16 ;Y.�A"''F. CITY OF CARMEL, INDIANA VENDOR: 354772
`' '. CHECK AMOUNT: $*******225.00*
.�; �• ONE CIVIC SQUARE JAMES R HAWKINS
9 ,;�; CARMEL, INDIANA 46032 12442 HEATHERSTONE PLACE CHECK NUMBER: 304029
MUTON�; CARMEL IN 46033 CHECK DATE: 10/10/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1192 4343004 3RDQTR16 225.00 TRAVEL PER DIEMS
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
JAMES R HAWKINS ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
12442 HEATHERSTONE PLACE IN SUM OF$ 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.
$225.00 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
3rd qrtr BZA 43-430.04 $225.00 1 hereby certify that the attached invoice(s),or 10/3/16 3rd grtr BZA 3rd Quarter BZA meetings $225.00
1192 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
Wednesday, October 05,2016
Mike Hollibaugh
Director
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
Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer
Pg 2
2016
tu:Leo jjierckmanSTUreffiffaMMM4 Dennis Lockwood Earlene Plavchak Alan Potasnik Alternates
July 25 ':'75,"-- Z'�775 7i :21 75
"75
Aug 22 75
Sept 26 0:_751 C!,75f3� 75
Claims *225 47--5
225
Oct 24
Nov 28
Claims