164217 09/30/2008 ti CITY OF CARMEL, INDIANA VENDOR: 079250 Page 1 of 1
4 ONE CIVIC SQUARE JAY DORMAN CHECK AMOUNT: $375.00
CARMEL, INDIANA 46032 13506 BELFORD COURT
CARMEL IN 46032 CHECK NUMBER: 164217
CHECK DATE: 9/30/2008
DEPARTMENT ACCO P NU MBER INVOICE NUMBER AMO UNT DESCRIPTION T
1192 4343004 375.00. TRAVEL PER DIEMS
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 207 (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.
Payee
Jai Dorman Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
P lan
Ju 5• A Se 16
4 mtgs t? $75. $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.
20
Clerk- Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
Jay Dorman IN SUM OF
13506 Belford. Court
Carmel IN 46032
300.00
ON ACCOUNT OF APPROPRIATION FOR
Travel Per Diems 430 -04
Board Members
PO4 or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
1 p 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
S 20
Sig t re
Michael Holliba ah, Director
Title DoCs
Cost distribution ledger classification if
claim paid motor vehicle highway fund
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.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
X22 X �S
Total S �o
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.
ALLOWED 20
IN SUM OF
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO4 or INVOI E NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoi 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
20Q8
ure
�a s
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund