183311 03/16/2010 CITY OF CARMEL, INDIANA VENDOR: 362448 Page 1 of 1
,I ONE CIVIC SQUARE PATRICIA HACKETT
CARMEL, INDIANA 46032 12432 GLENDURGAN DRIVE CHECK AMOUNT: $150.00
CARMEL IN 46032
o CHECK NUMBER.: 183311
CHECK DATE: 311 612 01 0
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4341999 0210 150.00 OTHER PROFESSIONAL FE
t
Carm 0 Clay
Parks &R ecreation CHECK REQUEST
Date: 3/112010 f9i� 201U i
Check payable to
Name: Patricia Hackett CCPR BOARD MEMBER
Address: 12432 Glendurgan Drive
City, State, Zip Carmel, IN 46032
X Mail check to payee Return check to requestor
Check Amount 150.00 Date Rectuired ASAP
Check needed for Monthly pay for meetings attended 219110,2111110,2123110
3 Meeting(s) (a) 50.00 each 150.00 February 2010
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
(I X
Requested by (signature): 01 PAZ mgljj 'Y]
Approved by (signature of Division Manager): (1v
on this date 3 �i
i
Form revised 7 -7 -08 Shared I Administrative Forms I Staff forms Check Request (rev 7 -7 -08)
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.
362448 Hackett, Patricia Terms
12432 Glendurgan Drive
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
311110 Feb'10 Park Board meeting attendance 150.00
Total 150.00
1 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
f
i
Voucher No, Warrant No.
362448 Hackett, Patricia Allowed 20
12432 Glendurgan Drive
Carmel, IN 46032
In Sum of
150.00
ON ACCOUNT OF APPROPRIATION FOR
101 General Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1125 Feb'10 4341999 150.00 1 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
11 -Mar 2010
`A+'h �'i?f twn e
Signature
150.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund