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194691 02/16/2011 CITY OF CARMEL, INDIANA VENDOR: 355613 Page 1 of 1 ONE CIVIC SQUARE JOE MILLER CARMEL, INDIANA 46032 13607 THISTLEWOOD DRIVE E CARMEL IN 46032 CHECK AMOUNT: $175.00 .o, CHECK NUMBER: 194691 CHECK DATE: 2/16/2011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1125 4341999 175.00 OTHER PROFESSIONAL FE Carmel oClay Parks &Recreation CHECK REQUEST Date: 2/1/2011 ©1 201 BY. EB......$ Check payable to Name: Joseph R Miller CCPR BOARD MEMBER Address: 13607 Thistlewood Dr. E. City, State, Zip Carmel IN 46032 X Mail check to payee Return check to requestor Check Amount 175.00 Date Required ASAP Check needed for Monthly pay for meetings attended 1/11/11 1 /15/11 1/25/11 2 Meeting(s) 0) $50.00 $100-00 1 meeting(s) (a) $75.00 75.00 January 2011 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): a�J-- on this date 4 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 2/1/11 Jan'11 Park Board meeting attendance 175.00 Total 175.00 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. 355613 Miller, Joseph R. Allowed 20 13607 Thistlewood Dr. E Carmel, IN 46032 In Sum of 175.00 ON ACCOUNT OF APPROPRIATION FOR 101 General Fund PO# or INVOICE NO. ACCT WTITLE AMOUNT Board Members Dept 1125 Jan'11 4341999 175.00 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 10 -Feb 2011 G'iYY� Signature 175.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund