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207132 03/13/2012 CITY OF CARMEL, INDIANA VENDOR: 363779 Page 1 of 1 t ONE CIVIC SQUARE JOSHUA ALBERT KIRSH CHECK AMOUNT: $225.00 CARMEL, INDIANA 46032 220 2ND AVE NE b yob CARMEL IA 46032 CHECK NUMBER: 207132 CHECK DATE: 3113/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1125 4341999 FE13 225.00 OTHER PROFESSIONAL FE Carmel 9 Cla Parks &Recreation CHECK REQUEST Date: 2/29/2012 Check payable to Name: Joshua Kirsh CCPR BOARD MEMBER Address: 220 Id Ave. NE City, State, Zip Carmel, IN 46032 X Mail check to payee Return check to requestor Check Amount 225.00 Date Required ASAP Check needed for Monthly pay for meetings attended 2/8/12,2/14/12,2/28/12 3 Meeting(s) (d each 225.00 February 2012 To be paid from PO (if applicable) N/A Budget account- GL 1125 -1 -01- 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)- l�Yl l/Yftl Approved by (signature of Division Manager): on this date 2 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. 363779 Kirsh, Joshua Terms 220 2nd Ave., NE Carmel, IN 46032 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO Amount 2129112 Feb'12 Monthly pay for meetings attended 225.00 Total 225.00 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. 363779 Kirsh, Joshua Allowed 20 220 2nd Ave., NE Carmel, IN 46032 In Sum of 225.00 ON ACCOUNT OF APPROPRIATION FOR 101 -General Fund PO# or INVOICE NO. ACCT #MTLE AMOUNT Board Members Dept 1125 Feb'12 4341999 225.00 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 8 -Mar 2012 1 4� 6� Signature 225.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund