187275 07/07/2010 CITY OF CARMEL, INDIANA VENDOR: 00350721 Page 1 of 1
ONE CIVIC SQUARE LEO DIERCKMAN
CHECK AMOUNT: $300.00
CARMEL, INDIANA 46032 13316 KICKAP00 TRAIL
CARMEL IN 46033 CHECK NUMBER: 187275
CHECK DATE: 7/7/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1192 4343004 APR MAY JUNE 300.00 TRAVEL PER DIEMS
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Page 1 of 1
Tingley, Connie S
From: Tingley, Connie S
Sent: Wednesday, June 30, 2010 8:37 AM
To: Stewart, Lisa M
Subject: BZA claims
BZA attendance for April through June, 2010
Kent Broach $150 4 -26 -10 5 -24 -10
Leo Dierckman $150 4 -26 -10 5 -24 -10
James Hawkins $225 4- 26 -10, 5- 24 -10, 6 -28 -10
Earlene Plavchak $150 4 -26 -10 5 -24 -10
Madeleine Torres 75 4 -26 -10
Connie Tingley
BZA Secretary
571 -2419
6/30/2010
VOUCHER.NO. WARRANT NO.
Leo• Dierckman ALLOWED 20
IN SUM OF
13316 Kickapoo Trail
Carmel, IN 46033
$300.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel DOCS Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
1192 43- 430.04 $150.00 1 hereby certify that the attached invoice(s), or
1192 43- 430.04 $150.00 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
C r
wr
Thursda July 01, 2010
ct=DOCS
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed by State Board of Accounts _W City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER r'
CITY OF CARMEL r
An invoice or 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.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
06/17/10 Dierckman; 4/20, 6/15 $150.00
06/30/10 Apr May BZA mtgs $150.00
it
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