192635 12/10/2010 CITY OF CARMEL, INDIANA VENDOR: 354363 Page 1 of 1
q ONE CIVIC SQUARE JAMES L ENGLEDOW
CARMEL, INDIANA 46032 13851 RIVERWOOD WAY CHECK AMOUNT: $100.00
CARMEL IN 46032 CHECK NUMBER: 192635
CHECK DATE: 12110/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4341999 100.00 OTHER PROFESSIONAL FE
Carmel 0 Clay
'arks &Recreation CHECK REQUEST
Date: December 1, 2010
Check payable to:
Name: James En ledow CCPR BOARD MEMBER
Address: 13851 Riverwood Way
City, State, Zip Carmel IN 46032
X Maii check to payee Return check to requestor
Check Amount 100.00 Date Required ASAP
Check needed for Monthly pay for meetings attended 11/4/10,11/23/10,
2 Meetings) $50.00 each 100.00 November 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): Paula Schlemmer
Requested by (signature):
Approved by (signature of Division Manager):
on this date
x D
EC
n 2 2010
Form revised 7 -7 -08 Shared Administrative Forms Staff forms I Check Request (rev 7 -7 -08)
BY:
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
1211110 Nov'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.
354363 Engledow, James Allowed 20
13851 Riverwood Way
Carmel, IN 46032
In Sum of
100.00
ON ACCOUNT OF APPROPRIATION FOR
101 General Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1125 Nov' 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
9 -Dec 2010
Signature
100.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund