205543 01/17/2012 CITY OF CARMEL, INDIANA VENDOR: 355613 Page 1 of 1
ONE CIVIC SQUARE JOE MILLER
CARMEL, INDIANA 46032 13607 THISTLEWOOD DRIVE E CHECK AMOUNT: $150.00
CARMEL IN 46032
CHECK NUMBER: 205543
CHECK DATE: 1117/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER A DESCRIPTION
1125 4341999 DEC'll 150.00 OTHER PROFESSIONAL FE
Carmel e Clay
Parks &Recreation CHECK REQUEST
Date: January 3, 2012 AN 0 3 2012
Check payable to
By:.... I.. Io.........
Name: Joseph R Miller CCPR BOARD MEMBER
Address: 13607 Thistlewood Dr. E.
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 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.
355613 Miller, Joseph R. Terms
13607 Thistlewood Dr. E
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
Voucher No. Warrant No.
355613 Miller, Joseph R. Allowed 20
13607 Thistlewood Dr. E
Carmel, IN 46032
In Sum of
150.00
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
Signature
150.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund