179191 11/11/2009 CITY OF CARMEL, INDIANA VENDOR: 00352834 Page 1 of 1
ONE CIVIC SQUARE DAN DUTCHER
CARMEL, INDIANA 46032 11583 SUTTON PLACE CHECK AMOUNT: $50.00
9 CARMEL IN 46032
4 CHECK NUMBER: 179191
CHECK DATE: 11111!2009
D EPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4341999 OCT 09 50.00 OTHER PROFESSIONAL FE
Carmel Clay
Parks &Recreation CHECK REQUEST
9w
Date: 11/3/2009 t
NOV 0 3 2009
Check payable to °b
Name: Daniel Dutcher CCPR BOARD MEMBER
Address: 11583 Sutton Place Drive
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 10/13/09
1 Meeting(s) (a, 50.00 each $50-00 October 2009
To be paid from
PO (if applicable) N/A
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 zjz�ej
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.
00352834 Dutcher, Daniel Terms
11583 Sutton Place Drive
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
1113!09 Oct'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- 10 -1.6
20_
Clerk Treasurer
Voucher No. Warrant No,
00352834 Dutcher, Daniel Allowed 20
11583 Sutton Place Drive
Carmel, IN 46032
i In Sum of
50.00
ON ACCOUNT OF APPROPRIATION FOR
101 -General Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
3125 Oct'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
5 -Nov 2009
Signature
50.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund