170873 04/16/2009 CITY OF'CARMEL, INDIANA VENDOR: 362448 Page 1 of 1
ONE CIVIC SQUARE TRICIA HACKETT
CARMEL, INDIANA 46032 12432 GLENDURGAN DRIVE CHECK AMOUNT: $1$0.00
CARMEL IN 46032
CHECK NUMBER: 170873
CHECK DATE: 4/1612009
DEPARTMENT ACCOUNT PO NU MBER INV OICE NUMBER AMO UNT DESCRIP
1125 J 4341999 MAR'09 150.00 OTHER PROFESSIONAL FE
i
Carmel 49 Clay
Parks &Recreation CHECK REQUEST
Date: April 6, 2009
Check payable to
Name: Paricia Hackett CCPR BOARD MEMBER
Address: 12432 Glendurgan Drive
City, State, Zip Carmel, IN 46032
I
X Mail check to payee Return check to requestor
Check Amount 150.00 Date Required ASAP
Check needed for Monthly pay for meetings attended 3/10/09 3/24/09 3/25/09
3 Meeting(s) an 50.00 each 150.00 March 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): Pa uu la Schlemmer
Requested by (signature):
Approved by (signature of Division Manager):
on this date 6 7
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.
362448 Hackett, Patricia Terms
12432 Glendurgan Drive
Carmel, IN 46032
i
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
4/6/09 Mar'09 Park Board meeting attendance 150.00
Total 150.00
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.
f
362448 Hackett, Patricia Allowed 20
12432 Glendurgan Drive
Carmel, IN 46032
In Sum of
150.00
ON ACCOUNT OF APPROPRIATION FOR
101 General Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1125 Mar'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
8 -Apr 2009
L hlmjm �j
Signature
150.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund