172583 05/13/2009 CITY OF CARMEL, INDIANA VENDOR: 354376 Page 1 of 1
ONE CIVIC SQUARE TIMOTHY P TOLSON
CARMEL, INDIANA 46032 110 SHOSHONE DRIVE CHECK AMOUNT: $150.00
CARMEL IN 46032
CHECK NUMBER: 172583
CHECK DATE: 5/1312009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4341999 APR09 150.00 OTHER PROFESSIONAL FE
a
r
C a rm el e Clay
Parks &Recreation CHECK REQUEST Lg N g
9
Date: 514109 �A Y 0 5 2009 �1
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 4/14/09,4/16/09,4/28/09
3 Meeting(s) 50.00 each 150.00 Aril 2009
To be paid from:
PO (if applicable) NIA
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): �1�/��?/�YJ! i I
Approved by (signature of Division Manager):
on this date 0
Form revised 7 -7 -08 Shared I Administrative Forms 1 Staff forms Check Request (rev 7 -7 -08)
.V
i ry 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.
Terms
354376 Tolson, Timothy
110 Shosone Drive
Carmel, IN 46032
Invoice Invoice Description PO Amount
Date Number (or note attached invoice(s) or bill(s)}
150.00
5I4109 A r'09 Park Board meeting attendance
Total 150.00
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.
354376 Tolson, Timothy Allowed 20
110 Shosone Drive
Carmel, IN 46032
In Sum of
i
150.00
ON ACCOUNT OF APPROPRIATION FOR
101 -General Fund
PO# or INVOICE NO. ACCT #[TITLE AMOUNT Board Members
Dept
1125 A r'09 4341999 150.00 1 hereby certify that the attached invoice(s), or
bilt(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 -May 2009
Signature
150.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund