174893 07/22/2009 CITY OF CARMEL, INDIANA VENDOR: 362449 Page 1 of 1
ONE CIVIC SQUARE JUDITH HAGAN
CARMEL, INDIANA 46032 10946 SPRING MILL LANE CHECK AMOUNT: $200.00
CARMEL IN 46032 CHECK NUMBER: 174893
CHECK DATE: 7/22/2009
DEPAR ACCOUN PO NUMBER I NVOICE NUMBER AMOUNT DESCRIPTION
1125 4341999 200.00 OTHER PROFESSIONAL FE
Carmel e Clay
Parks &Recre CHECK REQUEST
Date: July 3, 2009
Check payable to
Name: Judith Hagan CCPR BOARD MEMBER
Address: 10946 Spring Mill Lane
City, State, Zip Carmel IN 46032
X Mail check to payee Return check to requestor
Check Amount 200.00 Date Required ASAP
Check needed for Monthly pay for meetings attended 6/9/09,6/11/09,6/16/09,6/23/09
4 Meeting(s) (a $50.00 each $200.00 June 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. r i
UI U 3 7009
Requested by (print): y Paula Schlemmer
Requested by (signature): U •L
Approved by (signature of Division Manager): v
on this date 7/ U
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.
362449 Hagan, Judith Terms
10946 Spring Mill Lane
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
7/3/09 Jun'09 Park Board meeting attendance 200.00
Total 200.00
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.
362449 Hagan, Judith Allowed 20
10946 Spring Mill Lane
Carmel, IN 46032
In Sum of
200.00
ON ACCOUNT OF APPROPRIATION FOR
101 -General Fund
PO# or INVOICE NO. ACCT WTITLE AMOUNT Board Members
Dept
1125 Jun'09 4341999 200.00 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
16 -Jul 2009
Signature
200.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund