176254 08/19/2009 CITY OF CARMEL, INDIANA VENDOR: 362448 Page 1 of 1
ONE CIVIC SQUARE TRICIA HACKETT
CARMEL, INDIANA 46032 12432 GLENDURGAN DRIVE CHECK AMOUNT: $250.00
CARMEL IN 46032 CHECK NUMBER: 176254
CHECK DATE: 8/19/2009
DEPARTME ACCOUNT PO NUMBER IN VOICE NUMB AMO DES CRIP T ION
1125 4341999 JUL 09 250.00 OTHER PROFESSIONAL FE
Carmel 0 Choy
Parks &Recreation CHECK REQUEST
Date: August 3, 2009 AUG U 3 2009
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 250.00 Date Required ASAP
Check needed for Monthly pay for meetings attended 7/6/09,7/7/09,7/14/09,7/21/09,7/28/0
5 Meetinci(s) CaD- 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):
Approved by (signature of Division Manager):
on this date 8 A
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
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
8/3/09 Jul'09 Park Board meeting attendance 250.00
Total 250.00
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.
362448 Hackett, Patricia Allowed 20
12432 Glendurgan Drive
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