177634 09/29/2009 Page 1 of 1 VENDOR: 079250 Pa
CITY OF CARMEL, INDIANA 9
ONE CIVIC SQUARE JAY DORMAN
CARMEL, INDIANA 46032 13506 BELFORD COURT CHECK AMOUNT: $300.00
CARMEL IN 46032 CHECK NUMBER: 177634
CHECK DATE: 9/29/2009
DEPA RTMENT ACCOUN PO NUM INV OICE N AMOUNT DESCRIPTION
1192 4343004 300.00 TRAVEL PER DIEMS
Pagel of
Stewart, Lisa M
From: Hancock, Ramona B
Sent: Thursday, September 24, 2009 3:55 PM
To: Stewart, Lisa M
Subject: FW: Per Diem Claims for Plan Commission Members Hal Espey
Plan Commission Committee Meetings Attended:
Dierckman, Leo
Jul 07, 13, 21; Aug 4, 18; Sept 15
6 Mtgs $75. Total $450.00
Dorman, Jay
Qul-'2-1.,_Aug 1�8;-Sept 1 5--.
4 �Tkt1 $75. -T f 0 0-.--
Dutcher, Dan
Jul 7; Aug 4, 18; Sept 1, 15
5 Mtgs $75. Total $375.00
Grabow, Brad
Jul 7, 21; Aug 4, 18; Sept 1, 15
6 Mtgs $75. Total $450.00
Irizarry, Heather M*
Sept 1, 15
2 Mtgs 75. Total $150.
Ripma, Rick
Jul 21; Aug 4,18; Sept 1, 15
5 Mtgs $75. Total $375.
Schleif, Carol
Aug 4, 18; Sept 1, 15
4 Mtgs. $75. Total $300.'
Stromquist, Steve
Jul 7, 21; Sept 15
3 Mtgs $75. Total $225.00
Torres, Madeleine
Jul 21; Aug 4; Sept 15
3 Mtgs $75. Total $225.00
Westermeier, Sue
Jul 7, 21; Aug 4, 18; Sept 1
5 Mtgs. $75. Total $375.00
9/24/2009
Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or 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.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
09/23/09 Jay per diem for Plan Commission $300.00
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.
ALLOWED 20
Jay Dorman
IN SUM OF
13506 Belford Court
Carmel, IN 46032
$300.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel DOCS Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1192 43- 430.04 $300.00 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
t Monday, Septemb 28, 2009
V ir ectoy6Jcs
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund