HomeMy WebLinkAbout205443 01/17/2012 \,f CITY OF CARMEL, INDIANA VENDOR: 354363 Page 1 of 1
ONE CIVIC SQUARE JAMES L ENGLEDOW CHECK AMOUNT: $150.00
CARMEL, INDIANA 46032 13851 RIVERWOOD WAY
CARMEL IN 46032 CHECK NUMBER: 205443
CHECK DATE: 1/17/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4341999 DEC'11 150.00 OTHER PROFESSIONAL FE
Carm e Clay
Parks &Recreation CHECK REQUEST
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Date: January 3, 2012
I JAN Q 3 212
Check payable to
BM-LID
Name: James Engledow CCPR BOARD MEMBER
Address: 13851 Riverwood Way
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 12/13/11,12/19/11
2 Meeting(s) (a) $75.00 each 150.00 December 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 Sch
Requested by (signature): /���'l�L��/�V(
Approved b nature of Division Manager):
Pp Y si (9
on this date X f
Form revised 7 -7 -08 Shared Administrative Forms Staff forms Check Request (rev 7 -7 -08)
MEW
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.
354363 Engledow, James Terms
13851 Riverwood Way
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
1/3/12 Dec'11 Park Board meeting attendance 150.00
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
Allowed 20
In Sum of
�y� 150.00
Y,r PoS
ON ACCOUNT OF APPROPRIATION FOR
101 -General Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1125 Dec'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
11 -Jan 2012
lki
Signature
150.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
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