198540 06/22/2011 CITY OF CARMEL, INDIANA VENDOR: 362449 Page 1 of 1
i ONE CIVIC SQUARE JUDITH HAGAN CHECK AMOUNT: $150.00
CARMEL, INDIANA 46032 10946 SPRING MILL LANE
CARMEL IN 46032 CHECK NUMBER: 198540
CHECK DATE: 6/22/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4341999 MAY Ill 150.00 OTHER PROFESSIONAL FE
Car el e Clay
Parks &Recreation CHECK REQUEST
Date: 6/3/2011
Check payable to
Name: Judith Hagan CCPR BOARD MEMBER
Address: 10946 Spring Mill Lane
City, State, Zip Carmel IN 46032
X Mail check to payee Return check to requestor
Check Amount 150.00 Date Required ASAP
Check needed for Monthly pay for meetings attended 5/10/11,5/24/11
2 Meeting(s) (c) $75.00 each 150.00 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): Paula Schlemmer
Requested by (signature): uP/Y)'I,YY► 17
Approved b nature of Division Manager):
Pp by (9 9
on this date 6 3
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.
Terms
362449 Hagan, Judith
10946 Spring Mill Lane
Carmel, IN 46032
Invoice Invoice Description PO Amount
Date Number (or note attached invoice(s) or bill(s))
150.00
613111 Ma '11 Park Board meeting attendance
Total 150.00
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.
362449 Hagan, Judith Allowed 20
10946 Spring Mill Lane
Carmel, IN 46032
In Sum of
150.00
ON ACCOUNT OF APPROPRIATION FOR
101 General Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1125 Ma '11 4341999 150.00 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
Signature
150.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund