176470 08/19/2009 CITY OF CARMEL, INDIANA VENDOR: 354376 Page 1 of 1
0 ONE CIVIC SQUARE TIMOTHY P TOLSON
CHECK AMOUNT: $150.00
CARMEL, INDIANA 46032 110 SHOSHONE DRIVE
CARMEL IN 46032
CHECK NUMBER: 176470
CHECK DATE: 811912009
DEPARTMENT ACCOUNT PO NUMBER IN VOICE NUM AMOUNT DESCRIPTION
1125 4341999 150.00 OTHER PROFESSIONAL FE
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Carm Clay
Parks &Recreation CHECK REQUEST
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Date: August 3, 2009 3
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Check payable to
Name: Timothy Tolson CCPR BOARD MEMBER
Address: 110 Shosone Drive
City, State, Zip Carmel IN 46032
X Mail check to Payee Return check to requestor
Check Amount 150.00 Date Required ASAP
Check needed for Monthly pay for meetings attended 7/6/09,7/14/09,7/28/09
3 Meeting(s) na 50.00 each 150.00 July 2009
To be paid from:
PO (if applicable) N/A
Budget account GL 101-1125-4341999
Budget Line Description Other Professional Fees
Invoice(s) and Purchase Order (if required) MUST be attached.
Requested by (print): Paula Schlemmer
Requested by (signature):
Approved by (signature of Division Manager):
on this date
Form revised 7 -7 -08 Shared 1 Administrative Forms I 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.
354376 Tolson, Timothy Terms
110 Shosone Drive
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
8/3/09 Jul'09 Park Board meeting attendance 150.00
Total 150.00
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
r
Voucher No. Warrant No.
354376 Tolson, Timothy Allowed 20
110 Shosone Drive
Carmel, IN 46032
In Sum of
150.00
ON ACCOUNT OF APPROPRIATION FOR
101 General Fund
PO# or INVOICE N0. ACCT WTITLE AMOUNT Board Members
Dept
1125 Jul'09 4341999 150.00 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
13 -Aug 2009
Signature
150.00 Accounts Payable Coordinator
Cost distribution ledger classification it Title
claim paid motor vehicle highway fund