174825 07/22/2009 CITY OF CARMEL, INDIANA VENDOR: 354361 Page 1 of 1
ONE CIVIC SQUARE SUSANNAH H DILLON
y 0 CARMEL, INDIANA 46032 CHECK AMOUNT: $100.00
507 CORNWALL CT
CARMEL IN 46032 CHECK NUMBER: 174825
CHECK DATE: 7/22/2009
D EPARTME NT ACCOUNT PO NUMBER INVO NUMBER AMOUNT DESCRIPTION
N 1125 4341999 JUN 09 100.00 OTHER.PROFESSIONAL, FE
-k
Carmel Clay
Parks &Recreation CHECK REQUEST
Date: July 3, 2009
Check payable to
Name: Susannah Dillon CCPR BOARD MEMBER
Address: 507 Cornwall Court
City, State, Zip Carmel, IN 46032
X Mai! check to payee Return check to requestor
Check Amount 100.00 Date Required ASAP
Check needed for Monthly pay for meetings attended 619109,6123109
2 Meeting(s) (cD $50.00 each $100.00 June 2009
To be paid from
PO (if applicable) NIA
Budget account GL 101 -1125- 4341999
Budget Line Description Other Professional Fees
1nvoice(s) and Purchase Order (if required) MUST be attached.
U JILL 0 3x'009 v
Requested by (print): Paula Schlemmer
Requested by (signature):
Approved by (signature of Division Manager):
on this date `j
Form revised 7 -7 -08 Shared Administrative Forms Staff forms 1 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
7!3!09 Jun'09 Park Board meeting attendance 100.00
Total 100,00
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
t
Voucher No. Warrant No.
354361 Dillon, Susannah Allowed 20
507 Cornwall Court
Carmel, IN 46032
In Sum of
100.00
ON ACCOUNT OF APPROPRIATION FOR
101 -General Fund
PO# or INVOICE NO. ACCT #1TITLE AMOUNT Board Members
Dept
1125 Jun'09 4341999 100.00 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
16 -Jul 2009
Signature
100.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund