319943 12/21/17 ..Gqq
u *F CITY OF CARMEL, INDIANA VENDOR: 354772
Via:�� �.
.;, � �I• ONE CIVIC SQUARE JAMES HAWKINS
CHECK AMOUNT: $*******150.00*
CARMEL, INDIANA 46032 12442 HEATHERSTONE PLACE CHECK NUMBER: 319943
by.___.'� CARMEL IN '46033 CHECK DATE: 12/21/17
IiDN
DEPARTMENT ACCOUNT_ PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1192 4343004 150.00 TRAVEL PER DIEMS
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995)
Vendor# 354772 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
JAMES HAWKINS IN SUM OF$ CITY OF CARMEL
12442 H EATH ERSTON E 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
$150.00
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
Hawkins 43-430.04 $150.00 1 hereby certify that the attached invoice(s),or 12/20/17 Hawkins BZA Meetings Oct 23 and Nov 27,2017 $150.00
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 i -.lassification if claim paid motor vehicle highway fund. Clerk-Trea
Pg 2
2017.
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
Oct 23 �(� `� 5 �l�-0 -76 VA D rt if...
Nov 27 ''� 5 '� � 5 � �J CJ �1 Ukq �fl
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