HomeMy WebLinkAbout160828 06/25/2008 CITY OF CARMEL, INDIANA VENDOR: 00350721 Page 1 of 1
is 0 °j•' ONE CIVIC SQUARE LEO DIERCKMAN CHECK AMOUNT: $300.00
CARMEL, INDIANA 46032 13316 KICKAPOO TRAIL
CARMEL IN 46033 CHECK NUMBER: 160828
CHECK DATE: 6/25/2008
DEPARTMENT ACCOUNT PO NUM INV NUMBER AM OUNT DE
P1192 4343004 300.00 TRAVEL PER DIEMS
I
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
CITY OF CARMEL
An invoice or 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.
i
Payee
e Di >W' an Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
m ay 20 June 17
300.00
Total
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.
1 20
Clerk Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
Leo Dierckman IN SUM OF
13316 Kickapoo Trail
Carmel IN 4533
3oo.nn
ON ACCOUNT OF APPROPRIATION FOR
Travel Per Diem #430 -04
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
1192 430-04 0 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
a3
J 20 0 3
Si na ure
Cost distribution ledger classification if
claim paid motor vehicle highway fund