176255 08/19/2009 CITY OF CARMEL, INDIANA VENDOR: 362449 Page 1 of 1
ONE CIVIC SQUARE JUDITH HAGAN
CARMEL, INDIANA 46032 10946 SPRING MILL LANE CHECK AMOUNT: $250.00
CARMEL IN 46032
CHECK NUMBER: 176255
CHECK DATE: 8/19/2009
D EPARTMENT ACCOUNT PO N UMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4341999 JUL 09 250.00 OTHER PROFESSIONAL FE
Carrel e Clay
Parks &Recreation CHECK REQUEST
Date: August 3, 2009 AUG 0 3 2009
Check payable to BY-.1'.J.
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 250.00 Date Required ASAP
Check needed for Monthly pay for meetings attended 7/6/09,7/7/09,7/14/09,7/21/09,7/28/09
5 Meeting(s) C) $50.00 each 250.00 July 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): Paula Schlemmer
Requested by (signature): �A�.YP�Y1�/yl2m
Approved by (signature of Division Manager):
on this date f Z-2 /0-
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.
Terms
362449 Hagan, Judith
10946 Spring Mill Lane
Carmel, IN 46032
Invoice Invoice Description Amount
or note attached invoice(s) or bill(s)) PO
Date Number 250.00
813109 Jul'09 Park Board meeting attendance
ffl$250.0
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
1 20
Clerk- Treasurer
Voucher No. Warrant No.
362449 Hagan, Judith Allowed 20
10946 Spring Mill Lane
Carmel, IN 46032
In Sum of
250.00
ON ACCOUNT OF APPROPRIATION FOR
101 -General Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1125 Jul'09 4341999 250.00 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
250.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund