179230 11/11/2009 CITY OF CARMEL, INDIANA VENDOR: 362448 Page 1 of 1
ONE CIVIC SQUARE TRICIA HACKETT CHECK AMOUNT: $100.00
CARMEL, INDIANA 46032 12432 GLENDURGAN DRIVE
CARMEL IN 46032 CHECK NUMBER: 179230
CHECK DATE: 11/11/2009
D EPARTMENT ACCOUNT PO NUM BER INVOICE NUMBE AMOUNT DESCRIPTION
1125 4341999 100.00 OTHER PROFESSIONAL FE
Carmel Clay
Parks &Recreation CHECK REQUEST
t 7 U 3 9 I
Date: 11/3/2009 y NOV 0 3 2009
BY. I
Check payable to
Name: Paricia Hackett CCPR BOARD MEMBER
Address: 12432 Glendurgan Drive
City, State, Zip Carmel IN 46032
X Mail check to payee Return check to requestor
Check Amount 100.00 Date Required ASAP
Check needed for Monthly pay for meetings attended 10/13/09,10/27/09
2 Meeting(s) Cad 50.00 each 100.00 October 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):
Approved by (signature of Division Manager):
on this date
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
i
Purchase Order No.
362448 Hackett, Patricia Terms
12432 Glendurgan Drive
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
11/3/09 Oct'09 Park Board meeting attendance 100.00
Total 100.00
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.
362448 Hackett, Patricia Allowed 20
12432 Glendurgan Drive
Carmel, IN 46032
In Sum of
100.00
ON ACCOUNT OF APPROPRIATION FOR
101 General Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1125 Oct'09 4341999 100.00 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
5 -Nov 2009
Signature
100.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund