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HomeMy WebLinkAbout304111 10/10/16 0J^Y' *",. CITY OF CARMEL, INDIANA VENDOR: 357681 1 ONE CIVIC SQUARE ALAN POTASNIK CHECK AMOUNT: $*******225.00* a CARMEL, INDIANA 46032 12482 CHARING CROSS CHECK NUMBER: 304111 9�\'�i roei�°' CARMEL IN 46033 CHECK DATE: 10/10/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1192 4343004 3RDQTR16 225.00 TRAVEL PER DIEMS VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) ALAN POTASNIK ALLOWED 20 ACCOUNTS PAYABLE VOUCHER 12482 CHARING CROSS IN SUM OF$ 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 Qrtr BZ4 $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 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 t1jeo"bie'ic'kman James Hawkins RmnisrLockwoW- Earlene Plavchak Alan t tas ik Alternates July 25 07, 5 V7-577 Aug 22 75` 7 !�75 Sept 26 =75` 75 75 X75 SIS 5-- Claims 225 425 Oct 24 Nov 28 Claims