190726 10/13/2010 CITY OF CARMEL, INDIANA VENDOR: 354361 Page 1 of 1
ONE CIVIC SQUARE SUSANNAH H DILLON
CARMEL, INDIANA 46032 507 CORNWALL CT CHECK AMOUNT: $100.00
CARMEL IN 46032 CHECK NUMBER: 190726
CHECK DATE: 10/1312010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4341999 100.00 PER DIEM
Car MCI 0 Clay
Parks &Recreation CHECK REQUEST
Date: October 4 2010
0 L 0 4- 2010
Check payable to By; A! Jl
Name: Susannah Dillon CCPR BOARD MEMBER
Address: 507 Cornwall Court
City, State, Zip Carmel IN 46032
X Mail check to payee Return check to requestor
Check Amount 100.00 Date Required ASAP
Check needed for Monthly pay for meetings attended 9/14/10,9/18/10
2 Meeting(s) (a) $50.00 each $100.00 September 2010
To be aimed from:
PO (if applicable) NIA
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):
i
on this date
Form revised 7 -7 -08 Shared I 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
1014110 Sep'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
20_
Clerk- Treasurer
Voucher No. Warrant No.
354361 Dillon, Susannah Allowed 20
507 Cornwall Court
Carmel, IN 46032
In Sum of
100.00
ON ACCOUNT OF APPROPRIATION FOR
101 -General Fund
PO# or INVOICE NO. ACCT #FIFITLE AMOUNT Board Members
Dept
1125 Sep'10 4341999 100.00 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
7 -Oct 2010
Signature
100.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund