178420 10/14/2009 w CITY OF CARMEL, INDIANA VENDOR: 354376 Page 1 of 1
ONE CIVIC SQUARE TIMOTHY P TOLSON
s CHECK AMOUNT: $150.00
CARMEL, INDIANA 46032 110 SHOSNQNE DRIVE
CARMEL IN 46032 CHECK NUMBER: 178420
CHECK DATE: 10114!2009
DEPARTMENT ACCOUNT PO NU MBER I NVOICE NUMBER AMOUNT DESCRIPTION
1125 4341999 SEP 09 150.00 OTHER PROFESSIONAL FE
f I
Ca rmel 0 Clay
Parks &Recreation CHECK REQUEST
Date: 10/5/2009
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 918109 9110/09 9/22/09
3 Meeting(s) a- 50.00 each 150.00 Sept. 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 I 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
1 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
10/5109 Se '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
1 20
Clerk- Treasurer
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. A.CCT AMOUNT Board Members
Dept
1125 Se '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
7 -Oct 2009
Signature
150.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund