173797 06/24/2009 CITY OF CARMEL, INDIANA VENDOR. 00350721 Page 1 of 1
1. ONE CIVIC SQUARE LEO DIERCKMAN
F CARMEL, INDIANA 46032 13316 KICKAP00 TRAIL CHECK AMOUNT: $225.00
'tiy CARMEL IN 46033 CHECK NUMBER: 173797
CHECK DATE: 6/24/2009
DEPARTMENT ACC OUNT PO NUMB INVOICE NU MBER AM OUNT DESCRIPTION
1192 4343004 225.00 TRAVEL PER DIEMS
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))
06/22/09 Plan Commission meetings $225.00
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.
ALLOWED 20
Leo Dierckman
IN SUM OF
13316 Kickapoo Trail
Carmel, IN 46033
$225.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel DOCS Department
PO# Dept. INVOICE NO. ACCT #fTITLE AMOUNT Board Members
1192 43- 430.04 $225.00 i 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
Mo ay, June 22, 2009
Director, YCS
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund