186393 06/09/2010 CITY OF CARMEL, INDIANA VENDOR: 363779 Page 1 of 1
o ONE CIVIC SQUARE JOSHUA ALBERT KIRSH
CARMEL, INDIANA 46032 2202ND AVE NE CHECK AMOUNT: $50.00
CARMEL IA 46032
CHECK NUMBER: 186393
CHECK DATE: 6/9/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4341999 50.00 OTHER PROFESSIONAL FE
Caramel e Clay
Parks &Recreation CHECK REQUEST
Date: 6/2/2010
JINN 0 2 2010
Check payable to
Name: Joshua Kirsh CCPR BOARD MEMBER
Address: 220 2 Ave. NE
City, State, Zip Carmel. IN 46032
X Mail check to payee Return check to requestor
Check Amount 50.00 Date Required ASAP
Check needed for Monthly pay for meetings attended 5111110
1 Meeting(s) (o)- $50.00 each 50.00 May 2010
To be paid from
PO (if applicable) NIA
Budget account GL 101 1125 4341999
Budget Line Description Other Professional Fees
Invoke(s) and Purchase Order (if required} MUST be attached.
Requested by (print): Paula Schlemmer
Requested by (signature): JI
Approved by (signature of Division Manager):
on this date O U �_j
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.
r
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
612110 Ma '10 Park Board meeting attendance 50.00
Total 50.00
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.
363779 Kirsh, Joshua Allowed 20
220 2nd Ave., NE
Carmel, IN 46032
In Sum of
50.00
ON ACCOUNT OF APPROPRIATION FOR
101 -General Fund
PO# or INVOICE NO. ACCT #1TITLE AMOUNT Board Members
Dept
1125 Ma '10 4341999 50.00 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
3 -Jun 2010
Signature
50.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund