177499 09/22/2009 CITY OF CARMEL, INDIANA VENDOR: 363352 Page 1 of 1
ONE CIVIC SQUARE WES NICLEY CHECK AMOUNT: $2,500.00
CARMEL, INDIANA 46032 4544 W 200 N
LEBANON IN 46052 CHECK NUMBER: 177499
s CHECK DATE: 9/22/2009
DEPARTMENT ACCO PO NU MBER INVOICE NUMBER AMOUN DE SCRIPTION
301 5023990 2,500.00 ADOPTION ASSISTANCE
Lingelbaugh, Shelly M
From: Lamb, Barbara A
Sent: Friday, September 18, 2009 4:52 PM
To: Lingelbaugh, Shelly M
Subject: Adoption Claim
Shelly, on Monday please submit a claim against the medical account for Wes Nicley (adoption expenses) in the amount
of $2,500. Please have Cindy give the check to me so I can send it to Wes with a letter. Thanks.
Barbara A. Lamb
Director of Human Resources
City of Carmel
One Civic Square
Carmel, IN 46032
Phone: 317 -571 -2471
Fax: 317 -571 -2409
Email: blamb(eDcarmel.in.gov
Please consider the em ironment before printing this e -mail
Pre, -ribed by State lard of A ccounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or 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.
Wes Nicely Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
09/21/09 Adoption Expenses
$2,500.00
Total
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 N0 /21 /09 WARRANT NO.
ALLOWED 20
IN SUM OF
e
$2,500.00
ON ACCOUNT OF APPROPRIATION FOR
301 Medical Funds Escrow
Board Members
PO# or D PT. INVOICE NO. ACCT #/TITLE AMOUNT I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
MeEleea 52,0U0.00 materials or services itemized thereon for
which charge is made were ordered and
received except
20
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund