205614 01/17/2012 a CITY OF CARMEL, INDIANA VENDOR: T362065 Page 1 of 1
ONE CIVIC SQUARE RICHARD TAYLOR
CHECK AMOUNT: $150.00
14� CARMEL, INDIANA 46032 3220E 104TH STREET
CARMEL IN 46033 CHECK NUMBER: 205614
CHECK DATE: 1/17/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4341999 DEC11 150.00 OTHER PROFESSIONAL FE
Carmel Clay
Parks &Recreation CHECK REQUESTm TR U R R V YR
Date: January 3, 2012 JAN 0 3 2O1Z LID BY:............
Check payable to
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 150.00 Date Required ASAP
Check needed for Monthly pay for meetings attended 12/13/11,12/19/11
2 Meeting(s) Co? $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): Pula Schlemmer
Requested by (signature): 8
Approved b (signature of Division Manager):
Pp Y 9
on this date 7--
Form revised 7 -7 -08 Shared Administrative Forms I Staff forms I 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
113112 Dec'11 Park Board meeting attendance 150.00
Total 150.00
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.
T362065 Taylor, Richard F. III Allowed 20
3220 East 104th Street
Carmel, IN 46033
In Sum of
150.00
ON ACCOUNT OF APPROPRIATION FOR
101 General Fund
PO# or INVOICE NO. ACCT #1TITLE 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
djilz Lh�
Signature
150.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund