184500 04/14/2010 CITY OF CARMEL, INDIANA VENDOR: T362065 Page 1 of 1
ONE CIVIC SQUARE RICHARD TAYLOR
CARMEL, INDIANA 46032 10621 RUCKLE ST CHECK AMOUNT: $250.00
INDIANAPOLIS IN 46280 CHECK NUMBER: 184500
CHECK DATE: 4/14/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4341999 250.00 OTHER PROFESSIONAL FE
C armel Clay
Parks &Recreation CHECK REQUEST
Date: 411110 APR a 1
Check a v able to BY"
Name: Richard F. Taylor III CCPR BOARD MEMBER
Address: 10621 Ruckle Street
City, State, Zip Indianapolis IN 46280
X Mail check to payee Return check to requestor
Check Amount 250.00 Date Required ASAP
Check needed for Monthly pay for meetings attended 3/6/10,3/9110,3/11/10,3/16/10,3/23/10
5 Meeting(s) (a $50.00 each 250.00 March 2010
To be paid from
PO (if applicable) NIA
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):
on this date
Form revised 7 -7 -08 Shared I Administrative I Forms Staff forms I 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.
T362065 Taylor, Richard F. III Terms
10621 Ruckle Street
Indianapolis, IN 46280
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
4/1110 Mar'10 Park Board meeting attendance 250.00
Total 250.00
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
Voucher No. Warrant No.
T362065 Taylor, Richard F. III Allowed 20
10621 Ruckle Street
Indianapolis, IN 46280
In Sum of
250.00
ON ACCOUNT OF APPROPRIATION FOR
101 -General Fund
PO# or INVOICE NO. ACCT#/TITILE AMOUNT Board Members
Dept
1125 Mar'10 4341999 250.00 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
250.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund