204409 12/06/2011 CITY OF CARMEL, INDIANA VENDOR: T362065 Page 1 of 1
ONE CIVIC SQUARE RICHARD TAYLOR CHECK AMOUNT: $225.00
CARMEL, INDIANA 46032 3220 E 104TH STREET
CARMEL IN 46033 CHECK NUMBER: 204409
CHECK DATE: 12/6/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4341999 NOV11 225.00 OTHER PROFESSIONAL FE
1
Carmel Clay
Parks &Recreation CHECK REQUEST
77
Date: December 1, 2011 (r I
J O 1, C O
Check payable to 111
�o ..1.x.....3........
Name: Richard F. Taylor III CCPR BOARD MEMBER
Address: 3220 East 104 Street
City, State, Zip Carmel, IN 46033
X Mail check to payee Return check to requestor
Check Amount 225.00 Date Required ASAP
Check needed for Monthly pay for meetings attended 11 /9/11 11/21/11,11/22/11
3 Meeting(s) (W $75.00 each 225.00 November 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):
Approved by (signature of Division Manager):
on this date
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.
T362065 Taylor, Richard F. III Terms
3220 East 104th Street
Carmel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
12/1/11 Nov'11 Park Board meeting attendance 225.00
Total 225.00
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
1 20_
Clerk- Treasurer
Voucher No. Warrant No.
T362065 Taylor, Richard F. III Allowed 20
3220 East 104th Street
Carmel, IN 46033
In Sum of
225.00
ON ACCOUNT OF APPROPRIATION FOR
101 General Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1125 Nov'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
1 -Dec 2011
Signature
225.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund