319918 12/21/2017 ggMf CITY OF CARMEL, INDIANA VENDOR: 00350524
d 1 ONE CIVIC SQUARE KENT BROACH CHECK AMOUNT: $**.....*75.00*
a CARMEL, INDIANA 46032 5023 ST CHARLES PLACE CHECK NUMBER: 319918
CARMEL IN 46033 CHECK DATE: 12/21/11
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1192 4343004 75.00 TRAVEL PER DIEMS
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
Vendor# 00350524 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
KENT BROACH IN SUM OF$ CITY OF CARMEL
5023 ST CHARLES PLACE An invoice or bill to be properly itemized must show:kind of service,where performed,dates service
rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
CARMEL, IN 46033
Payee
$75.00
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
Broach 43-430.04 $75.00 I hereby certify that the attached invoice(s),or 12/20/17 Broach Alternate for BZA Meeting Nov 7,2017 $75.00
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, December 20,2017
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
20Cost distribution Ii 1assification if claim paid motor vehicle highway fund. Clerk-Tres
Pg 2
2.017
Leo Dierckman James Hawkins Dennis Lockwood Earlene Plavchak Alan Potasnik Alternates
July 24 75 X 75 X X Kent Broach
75
Aug 28 75 75 75 75 75
Sept 25 75 75 X 75 75 Tim Moehl
75
Claims 225 150 150 150 150 Kent 75
Tim 75.
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Nov 27
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