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173933 06/24/2009 CITY OF CARMEL, INDIANA VENDOR: 362949 Page 1 of 1 ONE CIVIC SQUARE PATRICK MAUTNER CHECK AMOUNT: $222.25 CARMEL, INDIANA 46032 10203 PARKSHORE DRIVE FISHERS IN 46038 CHECK NUMBER: 173933 CHECK DATE: 6/24/2009 DEP ARTMENT ACCO PO NUMBER INVOICE NUMBER AM DESCRIPTION 1046 4340800 3 222.25 ADULT CONTRACTORS :I z 6 -a3 CI m CaFMel C C(a)/' �cuche Parks &Recreation CHECK REQUEST r q rneeci �a Date: 2 1 Loo p 5PM&W Check payable to I UN O i 2 2009 Name: c C cz a-� YLSLr �p T Address: S1(1 1dZd a k, p�Q City, State, Zip t"� S�(1e S WOO 3� Mail check to payee X Return check to requestor Check Amount 22 2 2 Date Required Une- Check needed for \jeYj6OC'�,[� �nVoi c 0c�3 To be paid from PO (if applicable) �1 r) 8 Budget account GL 210 ©O 4 Budget Line Description l 3.4 0 OO Ppogcrn, Supporting documentation or receipt(s) MUST be attached. Requested by (print): Y r �C^Y OY)S Requested by (signature): F Approved by (signature of Division Manager): I on this date O U Form revised 1 -21 -08 j rf t 1 T �`f f f z r. J r i t �r ,i: f__ ��,.1 1_.. s' i� t?� ..l 3 d, Patrick M autner INVOICE 10203 Parkshore Drive Fishers, IN 46038 t INVOICE #003 1, DATE: JUNE 2, 2009 TO: FOR: Carmel Clay Parks and Recreation Project and support assistance Alternative Minds Summer Program 1235 Central Park Drive East Carmel, IN 46032 317.698.4966 DESCRIPTION HOURS RATE AMOUNT June 22 -June 26 Providing 25 hrs of onsite support to Alternative Minds summer program, 25 /wk 222.25/wk 222.25 including map, history, and special activity projects for up to 30 children. Purchase 1 1 Description A I 1 l i nr y f'Vl �Y t P.O. Q09 P or F '.e JUN 0 2 '009 a.L Bud Purchase_ Date__,,,, APProv Date TOTAL $222.25 Make all checks payable to Patrick Mautner Thank you for your business! ACC_ OUKTS 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. 362949 Mautner, Patrick Terms 10203 Parkshore Drive Fishers, IN 46038 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO Amount 6/2109 3 Alt. minds program 6/22- 6/26/09 20892 D 222.25 Total 222.25 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. 362949 Mautner, Patrick Allowed 20 10203 Parkshore Drive Fishers, IN 46038 In Sum of 222.25 ON ACCOUNT OF APPROPRIATION FOR 104 Program Fund PO# or INVOICE NO. CCT #/TITL AMOUNT Board Members Dent 1046 3 4340800 222.25 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 18 -Jun 2009 Signature 222.25 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund