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184356 04/14/2010 CITY OF CARMEL, INDIANA VENDOR: 363779 Page 1 of 1 ONE CIVIC SQUARE JOSHUA ALBERT KIRSH CHECK AMOUNT: $150.00 CARMEL, INDIANA 46032 220 2ND AVE NE •or CARMEL IA 46032 CHECK NUMBER: 184356 CHECK DATE: 4/1412010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1125 4341999 MAR 10 150.00 OTHER PROFESSIONAL FE Carmel 0 lay Parks &Recreation CHECK REQUEST ]BORR 3 Date: APR 0 1 2010 Check payable to Name: Joshua Kirsh CCPR BOARD MEMBER Address: 220 Id Ave. NE City, State, Zip Carmel, IN 46032 X Mail check to payee Return check to requestor Check Amount 150.00 Date Required ASAP Check needed for: Monthly pay for meetings attended 3/9/10,3116/10,3/23/10 3 Meeting(s) Cad $50.00 each 150.00 March 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 Requested by (signature): Approved by (signature of Division Manager): 6' on this date /S_/U Form revised 7 -7 -08 Shared Administrative Forms 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. 363779 Kirsh, Joshua Terms 220 2nd Ave., NE Carmel, IN 46032 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO Amount 4/1110 Mar'10 Park Board meeting attendance 150.00 Total 150.00 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. 363779 Kirsh, Joshua Allowed 20 220 2nd Ave., NE Carmel, IN 46032 In Sum of 150.00 ON ACCOUNT OF APPROPRIATION FOR 101 General Fund PO# or INVOICE NO. ACCT #1TITL AMOUNT Board Members Dept ept 1125 Mar'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 8 -Apr 2010 Signature 150.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund