191752 11/10/2010 CITY OF CARMEL, INDIANA VENDOR: 355613 Page 1 of 1
0 ONE CIVIC SQUARE JOE MILLER CHECK AMOUNT: $150.00
CARMEL, INDIANA 46032 13607 THISTLEWOOD DRIVE E
CARMEL IN 46032 CHECK NUMBER: 191752
CHECK DATE: 11/10/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4341999 OCT'10 150.00 OTHER PROFESSIONAL FE
Carmel 0 Clay
Parks &Recreation CHECK REQUEST
D
T o. r
Date: November 1, 2010
Check payable to BY
Name: Joe Miller CCPR BOARD MEMBER
Address: 13607 Thistlewood Dr. E.
City, State, Zip Carmek IN 46032
X Mail check to payee Return check to requestor
Check Amount 150.00 Date Required ASAP
Check needed for Monthly a for meetings attended 10/12/10 10/14/10 10/26/10
3 Meeting(s) $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
lnvoice(s) and Purchase Order (if required) MUST be attached.
Requested by (print): Paula Schlemmer
Requested by (signat
Approved by (signature of Division Manager): b
on this date /I'/ —r b
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
Purchase Order No.
355613 Miller, Joseph R. Terms
13607 Thistlewood Dr. E
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
1111110 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.
355613 Miller, Joseph R. Allowed 20
13607 Thistlewood Dr. E
Carmel, iN 46032
In Sum of
150.00
ON ACCOUNT OF APPROPRIATION FOR
101 General Fund
PO# or INVOICE NO. ACCT #/TITLE 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
J e lk w
Signature
150.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund