185326 05/11/2010 CITY OF CARMEL, INDIANA VENDOR: 355133 Page 1 of 1
ONE CIVIC SQUARE AUDREY B KOSTRZEWA CHECK AMOUNT: $15,700.00
CARMEL, INDIANA 46032 2592 TURNING LEAF LANE
per CARMEL IN 46032 CHECK NUMBER: 185326
CHECK DATE: 5/11/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
109 5023990 2 15,700.00 MONON CHANGE FUND
y
Carmel a Clay
Parks &Recreation CHECK REQUEST
Date: May 12, 2010
Check payable to
Name: Audrey Kostrzewa
Address: Carmel Clay Parks Rec 1411 E. 116`" Street
City, State, Zip Carmel, IN 46032
Mail check to payee XX Return check to requesfor
Check Amount 15,700.00 Date Required asap
Check needed for Cash change fund increase for summer season
Supporting documentation or receipt(s) MUST be attached.
To be paid from
PO
Budget account GL 109- 5023990
Budget Line Description Unappropriated Funds
Requested by (print):
Requested by (signature):
Approved by (signature of Division Manager):
on this date
Form revised 1 -21 -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
whpm, rates per day, number of hours, rate per hour, number of units, price per unit, ect.
Payee Purchase Order
Audrey Kostrzewa Terms
Carmel Clay Parks Rec. Date Due
1411 E. 116th St., Carmel, IN 46032
Invoice Invoice Description Amount
Date Number. (or note attached invoice(s) or bill(s))
5/12110 Ck Request Cash change fund increase for summer season 2010 15,700.00
15,700.00
1 hereby certify that the attahced invoice(s), or bill(s) is (are) true and correct and I have audited same in accordance
with IC 5- 11- 10 -1.6
1 20
Clerk- Treasurer
1
oucher N Warrant No.
Kostrzewa, Audrey Allowed 20
In Sum of
DO NOT MAIL
15,700.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center Fund
PO# or Invoice NO. Account #/Title Amount Board Members
Dept
109 Ck Request 5023990 15,700.00 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
12-May 2010
gnature
15,700.00 ssistant Manager, Parks
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund