181228 01/13/2010 CITY OF CARMEL, INDIANA VENDOR: 362449 Page 1 of 1
`1 ONE CIVIC SQUARE JUDITH HAGAN CHECK AMOUNT: $200.00
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CARMEL, INDIANA 46032 10946 SPRING MILL LANE
i 5 CARMEL IN IN 46032 CHECK NUMBER: 181228
CHECK DATE: 1/13/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4341999 200.00 OTHER PROFESSIONAL FE
Carmel 0 Clay
Parks &Recreati.an CHECK REQUEST
n /"irrlir 7
Date: 1/4/2010
61/41 JAN 0 4 2010
Check payable to: Ya ...[:.L
Name: Judith Hagan CCPR BOARD MEMBER
Address: 10946 Spring Mill Lane
City, State, Zip Carmel, IN 46032
X Mail check to payee Return check to requestor
Check Amount: 200.00 Date Required: ASAP
Check needed for: Monthly pay for meetings attended 12/8/09,12/10/09,12 /17/09 ,12/22/09
4 Meeting(s) $50.00 each 200.00 December 2009
To be paid from:
PO (if applicable) N/A
Budget account GL 101-1125-4341999
Budget Line Description Other Professional Fees
Invoice(s) and Purchase Order (if required) MUST be attached
Requested by (print): Paula Schlemmer
Requested by (signature): P/Ofkitimtv
Approved by (signature of Division Manager): g
on this date
Form revised 7 -7 -08 Shared Administrative Forms Staff forms Check Request (rev 7 -7 -08)
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ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of bill to be properly itemized must show; kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
362449 Hagan, Judith Terms
10946 Spring Mill Lane
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
114/10 Dec'09 Park Board meeting attendance 200.00
Total 200.00
I hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and I have audited same in accordance
with IC 5- 11- 10 -1.6
20
Clerk- Treasurer
Voucher No. Warrant No.
362449 Hagan, Judith Allowed 20
10946 Spring Mill Lane
Carmel, IN 46032
In Sum of$
200.00
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ON ACCOUNT OF APPROPRIATION FOR
101 General Fund
PO# or Board Members
INVOICE NO. ACCT #!TITLE AMOUNT
Dept
1125 Dec'09 _4341999 200.00 I hereby certify that_the attached invoice(s), or
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
7 -Jan 2010
Signature
200.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund