205519 01/17/2012 CITY OF CARMEL, INDIANA VENDOR: 363779 Page 1 of 1
ONE CIVIC SQUARE JOSHUA ALBERT KIRSH CHECK AMOUNT: $75.00
CARMEL, INDIANA 46032 220 2ND AVE NE
CARMEL IA 46032 CHECK NUMBER: 205519
CHECK DATE: 1/17/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4341999 DEC'll 75.00 OTHER PROFESSIONAL FE
Carmel Tay
Parks &Recreation CHECK REQUEST RD
Date: January 3, 2012 JAN 0 3 2011
Check payable to BY' L 1
Name: Joshua Kirsh CCPR BOARD MEMBER
Address: 2202 Id Ave. NE
City, State, Zip Carmel, IN 46032
X Mail check to payee Return check to requestor
Check Amount 75.00 Date Required ASAP
Check needed for Monthly pay for meetings attended 12/19/11
1 Meeting(s) (c) $75.00 each 75.00 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): Pa Schlemmer
Requested by (signature): A�kkw`nbd4
Approved by (signatures 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.
363779 Kirsh, Joshua Terms
220 2nd Ave., NE
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
113112 Dec"! 1 Park Board meeting attendance
75.00
im
Total 75.00
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.
363779 Kirsh, Joshua Allowed 20
220 2nd Ave., NE
Carmel, IN 46032
In Sum of
75.00
ON ACCOUNT OF APPROPRIATION FOR
101 -General Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1125 Dec'11 4341999 75.00 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
L Wylmmy/
Signature
75.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund