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204727 12/20/2011 a CITY OF CARMEL, INDIANA VENDOR: 00350524 Page 1 of 1 ONE CIVIC SQUARE KENT BROACH II CHECK AMOUNT: $75.00 CARMEL, INDIANA 46032 5023 ST CHARLES PLACE '+y -off ca CARMEL IN 46033 CHECK NUMBER: 204727 CHECK DATE: 12/20/2011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1192 4343004 75.00 TRAVEL PER DIEMS Stewart, Lisa M From: Tingley, Connie S Sent: Friday, Decem ber 09, 2011 10:01 AM To: Stewart, Lisa M Subject: BZA claims BZA Claims for 4 th qtr: 75 Kent Broach Nov 28, 2011 'Y $225 Alan Potasnik Nov 1, Nov 28, Dec 6, 2 11 $150 James Hawkins Oct 24, Nov 28, 011 75 Earlene Plavchak f Nov 28, 2011✓ 75 Ephraim Wilfong Nov 28, 2011 BZA does not have any more scheduled meetings for 2011. Please let me know if you need any further information. Connie 1 VOUCHER NO. WARRANT NO. ALLOWED 20 Kent Broach IN SUM OF 5023 St. Charles Place Carmel, IN 46033 $75.00 ON ACCOUNT OF APPROPRIATION FOR Carmel DOCS PO# Dept. INVOICE NO. I ACCT /TITLE AMOUNT Board Members 1192 43- 430.04 $75.00 I hereby certify that the attached invoice(s), or I 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 Monday, Decerjer 2011 Director Title Cost distribution ledger classification if claim paid motor vehicle highway fund Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995) ACCOUNTS PAYABLE VOUCHER 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)) 12/09/11 11/28/11 $75.00 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