191622 11/10/2010 CITY OF CARMEL, INDIANA VENDOR: 354363 Page 1 of 1
0 ONE CIVIC SQUARE JAMES L ENGLEDOW CHECK AMOUNT: $150.00
CARMEL, INDIANA 46032 13851 RIVERWOOD WAY
CARMEL IN 46032 CHECK NUMBER: 191622
CHECK DATE: 11/10/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4341999 150.00 OTHER PROFESSIONAL FE
Carmel lay
Parks &Recreation CHECK REQUEST
Date: November 1 2010 IE V M E ld PR
NOV a 12010
Check payable to I
Name: James En ledow CCPR BOARD MEMBER
Address: 13851 Riverwood Wa
City, State, Zip Carmel IN 46032
X Mail check to payee Return check to requestor
Check Amount 150.00 Date Required ASAP
Check needed for Monthly pay for meetings attended 10/12/10,10/14 10 10/26/10
3 Meeting(s) (a) $50.00 each 150.00 October 2010
To be paid 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): t Paula Schlemmer
Requested by (signature):
Approved by (signature of Division Manager):
on this date
Form revised 7 -7 -08 Shared 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
354363 Engledow, James Purchase Order No.
13851 Riverwood Way Terms
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO
Amount
11/1/10 Oct'10 Park Board meeting attendance
150.00
Total 150.00
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.
354363 Engledow, James Allowed 20
13851 Riverwood Way
Carmel, IN 46032
In Sum of
150.00
ON ACCOUNT OF APPROPRIATION FOR
101 -General Fund
PO# or INVOICE NO. ACCT #FFITLE AMOUNT Board Members
Dept
1125 Oct' 10 4341999 150.00 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
4 -Nov 2010
Signature
150.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund