178118 10/14/2009 CITY OF CARMEL, INDIANA VENDOR: 354361 Page 1 of 1
ONE CIVIC SQUARE SUSANNAH H DILLON
CARMEL, INDIANA 46032 507 CORNWALL CT CHECK AMOUNT: $54.00
+'r CARMEL IN 46032 CHECK NUMBER: 178118
CHECK DATE: 10/1412009
DEPARTMENT ACCOUN PO NUMBER INV OICE NUMBER AMOUNT DESCRIPTION
1125 4341999 SEP09 50.00 OTHER PROFESSIONAL FE
i
Carmel.e Clay
i Parks &Recreation CHECK REQUEST
Date: 10/5/2009
Check Payable to:
Name: Susannah Dillon CCPR BOARD MEMBER
Address: 507 Cornwall Court.
City, State, Zip Carmel, IN 46032
X Mail check to payee Return check to requestor
Check Amount 50.00 Date Required: ASAP
Check needed for Monthly pay for meetings attended 9122109
1 Meeting(s) $50.00 each 50.00 Sept. 2009
To be paid from
PO (if applicable) NIA
Budget account GL 101- 1125- 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 1 Administrative Forms 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.
354361 Dillon, Susannah Terms
507 Cornwall Court
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
10/5109 Se '09 Park Board meeting attendance 50.00
Total 50.00
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- 14 -1.6
20_
Clerk- Treasurer
Voucher No. Warrant No.
354361 Dillon, Susannah Allowed 20
507 Cornwall Court
Carmel, IN 46032
In Sum of
50.00
ON ACCOUNT OF APPROPRIATION FOR
101 General Fund
PO# or INVOICE NO. ACCT WTITLE AMOUNT Board Members
Dept
1125 Se '09 4341999 50.00 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
7 -Oct 2009
I L I ILZML
Signature
50.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund