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187917 07/21/2010 CITY OF CARMEL, INDIANA VENDOR: 363779 Page 1 of 1 ti1� ONE CIVIC SQUARE JOSHUA ALBERT KIRSH CHECK AMOUNT: $100.00 r. CARMEL, INDIANA 46032 2202ND AVE NE CARMEL IA 46032 CHECK NUMBER: 187917 CHECK DATE: 7/21/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1125 4341999 JUN 10 100.00 OTHER PROFESSIONAL FE Carm Clay Parks &Recreation CHECK REQUEST p Date: July 2 2010 J U 2 20 1 0 BY. ...,.......o 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 requester Check Amount 100.00 Date Required ASAP Check needed for: Monthly pay for meetings attended 6/8/10 2 Meeting(s) $50.00 each $100.00 June 2010 To be paid from PO (if applicable) N/A 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): J� Approved by (signature of Division Manager): on this date U J Form revised 7 -7 -08 Shared Administrative 1 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 z Purchase Order No. 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 7!2!10 Jun'10 Park Board meeting attendance 100.00 Total 100.00 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 1 20_ Clerk- Treasurer Voucher No. Warrant No. 363779 Kirsh, Joshua Allowed 20 220 2nd Ave., NE Carmel, IN 46032 In Sum of 100.00 ON ACCOUNT OF APPROPRIATION FOR 101 General Fund PO# or INVOICE NO. ACCT WTITILE AMOUNT Board Members Dept 1125 Jun'10 4341999 100.00 I 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 15 -Jul 2010 az, Signature 100.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund