173802 06/24/2009 CITY OF CARMEL, INDIANA VENDOR: 079250 Page 1 of 1
ONE CIVIC SQUARE JAY DORMAN CHECK AMOUNT: $300.00
CARMEL, INDIANA 46032 13506 BELFORD COURT
y�ioN io n CARMEL IN 46032 CHECK NUMBER: 173802
CHECK DATE: 6/24/2009
DEPARTM ACCO PO NUM BER INVOICE NUMBE AMOUNT DESCRIPTION
1192 4343004 300.00 TRAVEL PER DIEMS.
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))
06/22/09 Plan Commission Meetings $300.00
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.
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
Monday, June 22, 2009
Director, CS
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund