192633 12/10/2010 "c. CITY OF CARMEL, INDIANA VENDOR: 354361 Page 1 of 1
ONE CIVIC SQUARE SUSANNAH H DILLON
1 0� CHECK AMOUNT: $100.00
CARMEL, INDIANA 46032 507 CORNWALL CT
CARMEL IN 46032 CHECK NUMBER: 192633
CHECK DATE: 12/10/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4341999 100.00 OTHER PROFESSIONAL FE
Carmel 9 Clay
Parks &Recreation CHECK REQUEST
Date: December 1, 2010
Check payable to
Name: Susannah Dillon CCPR BOARD MEMBER
Address: 507 Cornwall Court
City, State, Zip Carmel IN 46032
X Mail check to payee Return check to requester
Check Amount 100.00 Date Required ASAP
Check needed for Monthly pay for meetings attended 1119110,11/15/10
2 Meeting(s) (a $50.00 each $100,00 November 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): 7�aaA� lYl!/yl2l���
Approved by (signature of Division Manager):
on this date 1,2-
IEC 022010
IRV
Form revised 7 -7 -08 Shared Administrative Forms! Staff forms Check Request (rev 7 -7 -08r
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.
Terms
354361 Dillon, Susannah
507 Cornwall Court
Carmel, IN 46032
Invoice Invoice Description PO Amount
Date Number (or note attached invoice(s) or bill(s))
100.00
1212110 Nov'10 Park Board meeting attendance
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 #1TITLE 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
0
k1ft/�ll/�l
Signature
100.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund