173968 06/24/2009 R CITY OF CARMEL, INDIANA VENDOR: 356305 Page 1 of 1
ONE CIVIC SQUARE DARRELL D NORRIS
O 101 2ND AVE SW, #2C CHECK AMOUNT: $39.25
CARMEL, INDIANA 46032
CARMEL IN 46032 CHECK NUMBER: 173968
CHECK DATE: 6/24/2009
DE PARTMENT ACCOUNT PO N UMBE R INVOICE NUM BER AMOUNT DESCRIPTION
";902 4359003 39.25 WINE FESTIVAL
STATE OF INDIANA
SS:
COUNTY OF HAMILTON
AFFIDAVIT
I, Darrell D. Norris, being duly sworn upon my oath, state that I personally expended the
following sums of money, in cash, to pay for attendance at the Vintage Indiana vinters
festival, on Saturday afternoon, June 6, 2009, to review the nature of the event, and the
manner in which the event was administrated, both as to general operation, and as to
compliance with Indiana liquor laws and public festivals, and wherein I obtained event
tokens: and for which I need to be reimbursed:
Admission Fee to Vintage Indiana (Non Alcohol, Designated Drive admission) 10.00
Two Event Wine Glasses (upon exiting) for CRC demonstration (2@ $5.00 /ea.) 1.0.00
Roundtrip Mileage to and from Carmel 35 miles 0.55 /mile 19.25) 19.25
TOTAL: 39.25
Dated this 8 day of June, 2009.
_'K7
Darrell D. Norris
Subscribed and sworn to before me, a Notary Public, this 9 day of
2009.
r
No ary Pu c
,A I C=L✓T /r(1L �55
Printed Name
Resident of /�//�/T/ County, Indiana
My Commission Expires: QC
Laic,
7 6
r/ C.
d r
ParUclpating Restaurants
Baskin Robbins
Barto s Banquets and Caterin t:IMITED 1. VIP. Tip k
Bazbeaux .Pizza
Cobb sFCajun Cooking f\dUl( i'Z I X In aCh r anCe
Emkay Concessions fi 2-5 at th �qctte
Glodo s Original Kettle -Korn
Joseph .Decuis ES1Cjn��t�C� ^(rldet I Or`r
:Jr: Chapt,er'of the American`i �gt?S, �(1`:
Culinar `Federation h e
Murphys Italian Ice.
Port a Pit Bar B Qpe of Indy x
1'e -kets-sold `i1T ad�'.ance; t Marsh Sup'erm
Par tlClpating Wf j' leS rtrcipating Indiana winc nes •Or online
Best Vineyards Winery
Brown County Winery y I
Buck Creek,
Wineiy. U(rltage ndl'and:COnlr
"'.Butler Winery& Vineyards'
'CarouselWinery
Gf ateau- de,Pique Wine sah� Ales inC,lirded -�vif h the purchase o an
Chateau Thomas adUlt ticket." ID regUtred.: Same °fcaod'
Easle Winer,
x y nOL'included: t-
Ertel ;Cellars Winery. j
French Lick Winery ti
Grape Winery
Huber.Orchard. Winery Vineyards
Indian Creek Winery; 3a Dar
Lanthier Winery r f�i
i For uro
Madison Vineyards e,�a
Mall owRun,Winery
Oliyer.Winery
MJ
Satek.Winery
Siriimons,Winery iB' Y
Thornas Family Winery WISH
Turtle Run Winery
Whyte. -Horse Winery
Windy KndiVinery
Winierwald.,Winery
Prescribed by State Board of Accounts 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.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
b 9/o 6 0 90 �v; o ,'v9l 3 9 ,2 5
d
Total 13 9
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.
nn ALLOWED 20
(✓�rrc° Q, /�/�r r r.
IN SUM O F
ON ACCOUNT OF APPROPRIATION FOR
50 2`y S9oo.3
Board Members
PO# or
DEPT INVOICE NO. ACCT #!TITLE AMOUNT I hereby certify that the attached invoice(s), or
oq 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
20 G9
Sign ure
Director of Operations
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund