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323521 03/29/18
4+ur..44gMff. CITY OF CARMEL, INDIANA VENDOR: 357681 d i ONE CIVIC SQUARE ALAN POTASNIK CHECK AMOUNT: $*"'"*'750.00* CARMEL, INDIANA 46032 12482 CHARING CROSS CHECK NUMBER: 323521 M_ioN. CARMELIN.'46033 CHECK DATE: 03/29/18 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1192 4343004 750.00 TRAVEL PER DIEMS VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995) Vendor# 357681 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER ALAN POTASNIK IN SUM OF$ CITY OF CARMEL 12482 CHARI NG CROSS 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' $750.00 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 Potasnik 43-430.04 $525.00 1 hereby certify that the attached invoice(s),or 3/23/18 Potasnik Plan Commission Meetings Jan-Mar $525.00 1192 101 1192 101 Potasnik 43-430.04 $225.00 bill(s)is(are)true and correct and that the 3/27/18 Potasnik BZA Meetings Jan-Mar $225.00 1192 101 materials or services itemized thereon for 1192 101 which charge is made were ordered and received except Tuesday, March 27,2018 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 distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer Meeting Dates y 1/22/2018 1/30/2018 2/26/2018 3/3/2018 3/26/2018 Total to Jan-Mar BZA Sth Tuesday BZA Workshop BZA Be Paid Names Alan Potasnik $ 75.00 - $ 75.00 - $ 75.00 $ 225.00 James R. Hawkins $ 75.00 - $ 75.00 $ 75.00 $ 75.00 $ 300.00 Leo Dierckman $ 75.00 - $ 75.00 $ 75.00 $ 75.00 $' 300.00 Earlene Plavchak $ 75.00 - - - $ 75.00 Dennis Lockwood $ 75.00 - $ 75.00 - $ 150.00 Brad Grabow - - $ 75.00 - $ 75.00 $ 150.00 Kent Broach $ 75.00 $ 75.00 TOTAL $ 1,275.00 Hollibaugh, Mike yes yes yes yes no Quarterly Claims-Attendance Spreadsheet 2018 Meeting Dates 1/2/2018 1/16/2018 1/30/2018 2/6/2018 2/6/2018 2/20/2018 3/3/2018 3/6/2018 . 3/20/2018 Totalto. Jan-Mar COM PC 5th Tuesday Executive COM PC Workshop COM PC Be Paid Names Adams,John W. $ 75.00 $ 75.00 $ 75.00 $ 75.00 $ 75.00 $ 75.00 $ 75.00 $ 75.00 $ 600.00 Casati, Michael $ - $ 75.00 $ 75.00 $ 75.00 $ 75.00 $ 75.00 $ 75.00 $ 75.00 $ 525.00 Grabow, Brad $ - $ 75.00 $ 75.00 $ 75.00 $ - $ 75.00 $ 75.00 $ - $ 75.00 $ 450.00 Kestner, Nick $ 75.00 $ 75.00 $ - $ 75.00 $ .75.00 $ - $ 75.00 $ 75.00 $ 450.00 Kirsh,Joshua $ - $ 75.00 $ - $ 75.00 $ 75.00 $ - $ 75.00 $ 75.00 $ 375.00 Lockwood, Dennis $ 75.00 $ 75.00 $ 75.00 $ 75.00 $ 75.00 $ - $ 75.00 $ - $ 450.00 Moehl,Tim $ 75.00 $ 75.00 $ 75.00 $ 75.00 $ 75.00 $ 75.00 $ 75.00 $ - $ 525.00 Potasn.ik,Alan_ $ 75.00 $ 75.00 $ 75.00 $ 75.00 $ 75.00 $ - $ 75.00 $ 75.00 $ 525.00 Westermeier,Susan $ 75.00 $ 75.00 $ 75.00 $ 75.00 $ 75.00 $ 75.00 $ 75.00 $ 75.00 $ 600.00 Tom Kegley $ 75.00 $ - $ - $ 75.00 $ 75.00 $ 75.00 $ 75.00 $ 75.00 $ 450.00 Bruce Kimball yes Laura Campbell yes yes yes yes -no yes yes Hollibaugh, Mike yes yes yes yes yes yes yes yes