HomeMy WebLinkAbout168942 02/17/2009 CITY OF CARMEL, INDIANA VENDOR: 354361 Page 1 of 1
ONE CIVIC SQUARE SUSANNAH H DILLON
CARMEL, INDIANA 46032 507 CORNWALL CT CHECK AMOUNT: $200.00
CARMEL IN 46032
CHECK NUMBER: 168942
r J CHECK DATE: 2/1712009
DEPARTMENT .ACCOUNT PO NUM INV OICE NUM BER AMOUNT DESCRIPTION
1125 4341999 JAN09�� 200.00 OTHER PROFESSIONAL FE
Carmele Clay
Parks &Recreation CHECK REQUEST
Date: 2113109
Check payable to
Name: Susannah Dillon CCPR BOARD MEMBER
501
Address: -407 Cornwall Court
City, State, Zip Carmel, IN 46032
X Mail check to payee Return check to requestor
Check Amount 200.00 Date Required ASAP
Check needed for Monthly pay for meetings attended
4 Meeting(s) aC�. $50.00 each= $200.00 January 2009
To be paid from
PO (if applicable) NIA
Budget account GL 101 -1125- 4341999
Budget Line Description Other Professional Fees
Invoice(s) and Purchase Order (if required) MUST be attached
Requested by (print): Paula Schlemmer
Requested by (signature):
Approved by (signature of Division Manager):
on this date 316 9 0
Form revised 7 -7 -08 Shared Administrative Forms Staff forms Check Request (rev 7 -7 -08)
ACCOUNTS PAYABLE VOUCHER
r Y; CITY OF CARMEL
An invoice of bill to be properly itemized must show; kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
354361 Dillon, Susannah Terms
507 Cornwall Court
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2112109 Jan'09 Park Board meeting attendance 200.00
Total 200.00
I hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and I have audited same in accordance
with IC 5- 11- 10 -1.6
,20
Clerk- Treasurer
Voucher No. Warrant No.
3''4361 Dillon, Susannah Allowed 20
507 Cornwall Court
Carmel, IN 46032
In Sum of$
200.00
ON ACCOUNT OF APPROPRIATION FOR
101 -General Fund
PO #or INVOICE NO. ACCT #/TITL AMOUNT Board Members
Dept
1125 Jan'09 4341999 200.00 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
13 -Feb 2009
j
Signature
200.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund