HomeMy WebLinkAbout198465 06/22/2011 a CITY OF CARMEL, INDIANA VENDOR: 365007 Page 1 of 1
ONE CIVIC SQUARE DONNA MARIE CIHAK HANSEN
CARMEL, INDIANA 46032 12122 ELLINGWOOD DR CHECK AMOUNT: $225.00
w <.oa 6o CARMEL IN 46032 CHECK NUMBER: 198465
CHECK DATE: 6/22/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4341999 MAY11 225.00 OTHER PROFESSIONAL FE
Carmel Clay
Parks &Recreation CHECK REQUEST
Date: 6/3/2011
Check payable to
Name: Donna Cihak Hansen CCPR BOARD MEMBER
Address: 12122 Ellingwood Drive
City, State, Zip Carmel IN 46032
X Mail check to payee Return check to requestor
Check Amount 225.00 Date Required ASAP
Check needed for Monthly pay for meetings attended 5/10/11,5/18/11,5/24/11
3 Meeting(s) $75.00 each 225.00 May 2011
To be paid from
PO (if applicable) N/A
Budget account GL 1125 -1 -01- 4341999
Budget Line Description Other Professional Fees
Invoice(s) and Purchase Order (if required) MUST be attached.
Requested by (print): Pau Schlemmer
Requested by (signature):
i
Approved by (signature of Division Manager):
on this dat
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.
365007 Cihak Hansen, Donna Terms
12122 Ellingwood Drive
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
6/3/11 Ma '11 Board meeting attendance 225.00
Total 225.00
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.
365007 Cihak Hansen, Donna Allowed 20
12122 Ellingwood Drive
Carmel, IN 46032
In Sum of
225.00
ON ACCOUNT OF APPROPRIATION FOR
101 General Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1125 Ma '11 4341999 225.00 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
16 -Jun 2011
Md4bMW
Signature
225.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund