180286 12/08/2009 CITY OF CARMEL, INDIANA VENDOR: 354376 Page 1 of 1
ONE CIVIC SQUARE TIMOTHY P TOLSON
CHECK AMOUNT: $50.00
CARMEL, INDIANA 46032 110 SHOSHONE DRIVE
CARMEL IN 46032
CHECK NUMBER: 180286
CHECK DATE: 121812009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4341999 NOV 09 50.00 OTHER PROFESSIONAL FE
(.'.ar e I e Clay
Parks &Recreation CHECK REQUEST
-3
Date: 11/30/09 Y
i NOV 3 0
Check payable to
Name: Timothy Tolson CCPR BOARD MEMBER
Address: 110 Shosone Drive
City, State, Zip Carmel IN 46032
X Mail check to payee Return check to requestor
Check Amount 50.00 Date Required ASAP
Check needed for Monthly pay for meetings attended 11/24/09
1 Meeting(s) (cry 50.00 each 50.00 November 2009
To be paid from
PO (if applicable) N/A
Budget account GL 101 1125- 4341999
Budget Line Description Other Professional Fees
Invoice(s) and Purchase Order (if required) MUST be attached.
Requested by (print): Paula Schlemmer
Requested by (signature):
Approved by (signature of Division Manager):
on this date
Form revised 7 -7 -08 Shared Administrative 1 Forms l Staff forms Check Request (rev 7 -7 -08)
V
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoic�,of bill to be properly itemized must show; kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
354376 Tolson, Timothy Terms
110 Shosone Drive
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
11/30/09 Nov'09 Park Board meeting attendance 50.00
Total 50.00
1 hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and I have audited same in accordance
with IC 5- 11- 10 -1.6
20_
Clerk- Treasurer
Voucher No. Warrant No.
354376 Tolson, Timothy Allowed 20
110 Shosone Drive
Carmel, IN 46032
l� In Sum of$
�F
50.00
ON ACCOUNT OF APPROPRIATION FOR
101 -General Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1125 Nov'09 4341999 50.00 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
3 -Dec 2009
Signature
50.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund