176210 08/19/2009 a CITY OF CARMEL, INDIANA VENDOR: .00352834 Page 1 of 1
ONE CIVIC SQUARE DAN DUTCHER
CARMEL, INDIANA 46032 11583 SUTTON PLACE CHECK AMOUNT: $150.00
CARMEL IN 46032 CHECK NUMBER: 176210
CHECK DATE: 8/19/2009
DEPART ACC OUNT PO NUMBER INVO NUMBER AM OUNT DESC RIPTION
1125 4341999 JUL 09 150.00 OTHER PROFESSIONAL FE
c
Carrel e Clay
Parks &Recrea�tion CHECK REQUEST
Date: August 3 2009 AUG 0 3 2009 U
Check payable to
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 $150.00 Date Required ASAP
Check needed for Monthly pay for meetings attended 7/6/09,7/14/ 9 7128109
3 Meeting(s) 50.00 each 150.00 July 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 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
813109 Jul'09 Park Board meeting attendance 150.00
Total 150.00
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
In Sum of
150.00
ON ACCOUNT OF APPROPRIATION FOR
101 -General Fund
PO# or INVOICE NO. ACCT #fTITLE AMOUNT Board Members
Dept
1125 Jul'09 4341999 150.00 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 -Aug 2009
Signature
150.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund