HomeMy WebLinkAbout185325 05/11/2010 CITY OF CARMEL, INDIANA VENDOR: 355133 Page 1 of 1
ONE CIVIC SQUARE AUDREY B KOSTRZEWA
CARMEL, INDIANA 46032 2592 TURNING LEAF LANE CHECK AMOUNT: $200.00
CARMEL IN 46032
CHECK NUMBER: 185325
CHECK DATE: 5/11/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1092 4358400 1 200.00 CHANGE FUND
CarmeleCl
Parks &Recreation CHECK REQUEST
Date: April 30, 2010
Check payable to
Name: Audrey Kostrzewa
Address: CCPR
City, State, Zip
Mail check to payee XX Return check to requestor
Check Amount 200.00 Date Required ASAP
Check needed for Replinish change fund at the Monon Community Center
Pursuant to Resolution B- 2010 -004 CCPR 4127/10 Board meeting
To be paid from
PO (if applicable)
Budget account GL 1092 4358400
Budget Line Description Refunds Awards Indemnities
Invoice(s) and Purchase Order (if required) MUST be attached.
Requested by (print): Paula Schlemmer
Requested by (signature):
Approved by (signature of Division Manager): b �J
on this date 0
Form revised 7 -7 -08 Shared 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.
355133 Kostrzewa, Audrey Terms
CCPR Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
04/30/10 Ck Request Re linish change fund at MCC $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
f
y
Voucher No. Warrant No.
355133 Kostrzewa, Audrey Allowed 20
CCPR
Carmel, IN 46032
In Sum of
200.00
f t
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1092 Ck Request 4358400 200.00 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
5 -May 2010
Signature
200.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
I