HomeMy WebLinkAbout304106 10/10/16 u/ 4�p.`� CITY OF CARMEL, INDIANA VENDOR: 370872
'� ONE CIVIC SQUARE BEN POLIZZI CHECK AMOUNT: $*****1,190.00*
d r,; CARMEL, INDIANA 46032 901 WAVELAND LANE CHECK NUMBER: 304106
'+.r........o, GREENWOOD IN 46143 CHECK DATE: 10/10/16
«ON�
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1701 4340400 092816 1,190.00 CONSULTING FEES
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995)
BEN POLIZZI ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
901 WAVELAND LANE IN SUM OF$ CITY OF CARMEL
An invoice or bill to be properly itemized must show:kind of service,where performed,dates service
GREENWOOD, IN 46143 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
$1,190.00 Payee
ON ACCOUNT OF APPROPRIATION FOR Purchase Order#
Clerk Treasurer 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
092816 43-404.00 $1,190.00 1 hereby certify that the attached invoice(s),or 9/28/16 092816 $1,190.00
1701 101 1701 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
Tuesday, October 04,2016
Linda Harvey
Chief Deputy Clerk Treasurer
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
20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer
n
EX HBIT B
Invoice
Data:
Nance of Company.
Address&Zip:
Telephone No.:
Fax No.:
Project Name:
Invoice No.
Purchase Order leo:
Goods Services
Person Providing Date Goods/Ser vices Provided Cost Per Hourly Total
Goods/Services Goods/ (Describe each good/service Item Rate/
Service separately and in detail) Hours
Provided Worked
a
GRAND TOTAL
Signa*e
Printed Name
NAME : Paten Poi<z2+
Sat Sun Mon Tue Wed Thu Fri Week Total
Payroll Week 1 q[2-& UP y!Z�/tCo 9/29,ltu alZq /icy a(3o/1�
Time In u2 qa
Time Out 3P 3p
Daily Hours O ® lZ
Approved By
Sat Sun Mon. Tue Wed Thu Fri Week Total
Payroll Week 2
Time In
Time Out
,Daily Hours
Approved By
*Round to the nearest 15 minutes. Ex: if you arrive at 3:49 you may put 3:45, if you arrive at 3:55 you must put 4:00
*Total time will be calculated on quarter hour basis: le; 1.75 hours or 2.25 hours
NAME INIi'ZZ1
Sat Sun Mon Tue Wed Thu Fri Week Total
Payroll Week 1 -7/i3 jicp Cl/141Co C, P(P f i�
Time In `la
Time Out UCP �p 3P �P
Daily Hours
Approved By
Sat Sun Mon. Tue Wed Thu Fri Week Total
Payroll Week 2 q lfo q f2filio C1AI IIke InIll
Time In el:60a q,% CA X12
Time Out
Daily Hours
Approved By
*Round to the nearest 15 minutes. Ex: if you arrive at 3:49 you may put 3:45, if you arrive at 3:55 you must put 4:00
*Total time will be calculated on quarter hour basis. le; 1.75 hours or 2.25 hours ,-�