HomeMy WebLinkAbout312089 6/5/2017 ,a ur tqq*�
CITY OF CARMEL, INDIANA VENDOR: 368254
ONE CIVIC SQUARE DNR CHECK AMOUNT: $x*.....110.00'
rq; CARMEL, INDIANA 46032 C/O FORT HARRISON STATE PARK CHECK NUMBER: 312089
5753 ND ANAPONISON aszis CHECK DATE: 06/05/17
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1082 4343007 6/22/17 110.00 FIELD TRIPS
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Eric I iolcomb,Governor
10019mok. Cameron Clark,Director
Indiana Department of Natural Resources
forl
5'/�3 (3-'Ierii I Road
lndii�napolis, IN 46216
Phone- 317-591-0904
FAX: 317-541-9532
INVOICE
Bill To: Date: May 16, 2017
Carmel Clay Parks and Recreation
Attn: Nancy Pittman
npittman@carmelclayparks.com
RE: Carmel Clay Parks Outing at FHSP June 22, 2017
Date Description Quantity Amount Owed
June 22, 2017 Outing @ $2.00 per person 55 $110.00
Total Amount Invoiced: $110.00
****Please make checks payable to: Indiana DNR
Air Equal Opportunity Employer
Printed on Recycled Paper
Carmel * Clay
Parks&Recreation CHECK REQUEST
Date: May 16,2017
z
2, 1017
Check payable to:
Name: Indiana DNR _.__
Address: 5753 Glenn Road
City,State,Zip: Indianapolis,IN 46216
Mail check to payee _X Return check to requestor
Check Amount:$110.00 Date Required:6/22/17
Purpose of Check:Fort Harrison State Park Field Trip
Supporting documentation or invoice(s)MUST be attached.
To be paid from:
PO#(if applicable)
Budget account-GL# 1082003
Budget Line Description: 4343007
Requested by(print): Nikeesha Pittrnan
Requested by(signature/date):
Approved by(print): � r � f `' ►`
Approved by(signature/date)
Form recreated 3/10/15(Business Services)