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190735 10/13/2010 CITY OF CARMEL, INDIANA VENDOR: 354363 Page 1 of 1 ONE CIVIC SQUARE JAMES L ENGLEDOW CARMEL, INDIANA 46032 13851 RIVERWOOD WAY CHECK AMOUNT: $200.00 CARMEL IN 46032 CHECK NUMBER: 190735 CHECK DATE: 10113/2010 DEPARTMENT ACCOUNT P NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1125 4341999 200.00 OTHER PROFESSIONAL FE Carmel Clay Parks &Recreation CHECK REQUEST Date: October 4 2010 201 Check pay able to J.0 Name: James En ledow CCPR BOARD MEMBER Address. 13851 Riverwood Way City, State, Zip Carmel IN 46032 X Mail check to payee Return check to requestor Check Amount $200.00 Date Required ASAP Check needed for Monthly pay for meetings attended 9/14/10,9/16/10,9/18/10 4 Meeting(s) CcD $50.00 each 200.00 September 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 Form revised 7 -7 -08 Shared 1 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. 354363 Engledow, James Terms 13851 Riverwood Way Carmel, IN 46032 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO Amount 1014/10 Sep'10 Park Board meeting attendance 200.00 Total 200.00 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. 354363 Engledow, James Allowed 20 13851 Riverwood Way Carmel, IN 46032 In Sum of 200.00 ON ACCOUNT OF APPROPRIATION FOR 101 General Fund PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members Dept 1125 Sep'10 4341999 200.00 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 200.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicVe highway fund