178371 10/14/2009 CITY OF CARMEL, INDIANA VENDOR: 00350380 Page 1 of 1
ONE CIVIC SQUARE ROCKHURST COLLEGE CONT ED CENTER CHE
CARMEL, INDIANA 46032 PO BOX 419107 CK AMOUNT: $398.00
KANSAS CITY MO 64141 -6107
CHECK NUMBER: 178371
CHECK DATE: 10/14/2009
DEPARTMENT ACCOU PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4357004 401069096001 398.00 EXTERNAL INSTRUCT FEE
Carmele Clay
Parks &Recreation CHECK REQUEST
17
Date: OC i
0 1 2009
Check payable to
Name: uv 1 t ln' V S i f USA 6�
Address: 0 L )C:'Y q) q l0 9
City, State, Zip
`I Mail check to payee Return check to requestor
Check Amount L ff oc) Date Required I D o1L
Check needed for
Supporting documentation or receipt(s) MUST be attached.
To be paid from
PO
Budget account GL c10� 3 S X 70 U
Budget Line Description (f -r ice- I 77—n-f- r 0 416 tl EPP. s
Requested by (print):
Requested by (signature):
Approved by (signature of Division Manager):
on this date
Form revised 1 -21 -08
1 f 7 ROCK14URST UNIVERSITY CONTINUING EDUCATION CENTER I INVOICE
NATIONAL SEMINARS GROUP PADGETT- THOMPSON kLYE PRODUCTIVITY COml'ED SOL'l
NAI''IONAL W O.MLiN'S Bt.ISINt SS I.,[.AUf. RSI IIPASSCX.`IAL'ION NAI'IONAL. PLLSS Pt'13L,ICKI'IONS
PO BOX 419107 800 682 5061 Flax 43 1576558
Kansas City, MO 64 141 6 1 0 7 http:/AvNvvv.natsem.cO77' F 91 432 0 824 lExemp fr ba ckup wi
PAYROLL LAW
INDIANAPOLIS 10/20/09
LISA BERRY 199.00
LYNN RUSSELL 199.00
0' C �'1
Y Uv9 r
H e
FOR BILLING QUESTIONS, PLEASE CALL 1 -800- 682 -5061 INVOICE# 401069096 -001
X
Remit to: please delach and return thLc
ROCKHURST UNIVERSITY CONTINUING FDUCAT'ION C FN'1'1?R, INC. portion with your payniew
PO Box 419107 Kansas City, !VIO 641 41 07
inv=oice no. invoice date terms balance. due
401069096 -001 9 -25 -09 NET RECEIPT 398.00
J Check here for name or address changes (please indicate corrections in address area below)
check
attached:
please charge to my:
CARMEL CLAY PARKS AND RECREATI J
J mastercard visa J amcrican express
1411 E 116TH STREET 16 digits I3 or 16 digiLs 15 digit~
Attn: LISA BERRY card
CARMEL, IN 46032 expiration date: LLLLJ
card
number:
cardholder
sig nature:
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.
00350380 Rockhurst University Con Ed Center, Inc. Terms
P.O. Box 419107
Kansas City, MO 64141 -6107
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
9/25/09 401069096001 Payroll Law 10/20/09 L.Berry, L.Russell 398.00
Total 398.00
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
1 20
Clerk- Treasurer
Voucher No. Warrant No.
00350380 Rockhurst University Con Ed Center, Inc. Allowed 20
P.O. Box 419107
Kansas City, MO 64141 -6107
In Sum of
398.00
ON ACCOUNT OF APPROPRIATION FOR
101 General Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1125 401069096001 4357004 398.00 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
7 -Oct 2009
Signature
398.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund