170129 03/18/2009 CITY OF CARMEL, INDIANA VENDOR: 354376 Pag 1 of 1
ONE CIVIC SQUARE TIMOTHY P TOLSON
CARMEL, INDIANA 46032 110 SHOSHONE DRIVE CHECK AMOUNT: $100.00
's!a� CARMEL IN 46032
CHECK NUMBER: 170129
CHECK DATE: 3118/2009
DEPARTMENT ACCOUNT PO NUMBE INVOICE NUMBER AMOUNT DESCRIPTION
1125 4341999 100.00 OTHER PROFESSIONAL FE
v,
1
Came] a Clay
Packs &Recreation CHECK REQUEST
Date: 313109 C'F I T ,T$ D
MAR 0 3 2009
Check payable to Y:
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 100.00 Date Required ASAP
Check needed for Monthly pay for meetings attended 212109 215109
2 Meeting(s) (a7 50.00 each $100.00 Feb -2009
To be p aid 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):
Approved by (signature of Division Manager): o
on this date 3 A
Form revised 7 -7 -08 Shared Administrative I Forms 1 Staff forms l 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)) Amount
100.00
313109 Feb'09 Park Board meeting attendance
Total 100.00
I hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and 1 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
100.00
ON ACCOUNT OF APPROPRIATION FOR
f:
101 General Fund
PO# or INVOICE NO. ACCT WTITLE AMOUNT Board Members
Dept
1125 Feb'09 4341999 100.00 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
12 -Mar 2009
Signature
100.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund