188780 08/18/2010 CITY OF CARMEL, INDIANA VENDOR: 354361 Page 1 of 1
ONE CIVIC SQUARE SUSANNAH H DILLON
CHECK AMOUNT: $50.00
CARMEL, INDIANA 46032 507 CORNWALL CT
;o� CARMEL IN 46032 CHECK NUMBER: 188780
CHECK DATE: 8/1812010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4341999 JUL 1 10 50.00 OTHER PROFESSIONAL FE
Carmel e Clay
Parks &Recreation CHECK REQUEST
Date: August 3, 2010 A I t (.1 0 3 10 10
B Y: /o
Check payable to
Name: Susannah Dillon CCPR BOARD MEMBER
Address: 507 Cornwall Court
City, State, Zip Carmel IN 46032
X Mail check to payee Return check to requesfor
Check Amount $50.00 Date Required ASAP
Check needed for Monthly pay for meetings attended 7/13/10
1 Meeting(s) (c) $50.00 each 50.00 July 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):
Approved by (signature of Division Manager):
on this date X13 d
Form revised 7 -7 -08 Shared Administrative 1 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.
354361 Dillon, Susannah Terms
507 Cornwall Court
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
813!10 ,lul'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.
354361 Dillon, Susannah Allowed 20
507 Cornwall Court
Carmel, IN 46032
In Sum of
50.00
ON ACCOUNT OF APPROPRIATION FOR
101 General Fund
PO# or INVOICE NO. 4LCT #fFITLE AMOUNT Board Members
Dept
1125 Jul'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
12 -Aug 2010
dOpw" u
Signature
I 50.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund