207934 04/10/2012 CITY OF CARMEL, INDIANA VENDOR: 363779 Page 1 of 1
ONE CIVIC SQUARE JOSHUA ALBERT KIRSH
CARMEL, INDIANA 46032 2202ND AVE NE CHECK AMOUNT: $225.00
CARMEL IA 46032 CHECK NUMBER: 207934
CHECK DATE: 4/1012012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4341999 MAR'12 225.00 OTHER PROFESSIONAL FE
Carmel Clay
Parks &Recreation CHECK REQUEST
Date: April 3, 2012 APR 0 3 2012 O
BY: .1 o
Check payable to
Name. Joshua Kirsh CCPR BOARD MEMBER
Address: 2202 Id Ave. NE
City, State, Zip Carmel IN 46032
X Mail check to payee Return check to requestor
Check Amount 225.00 Date Required ASAP
Check needed for Monthly pay for meetings attended 3113/12 3)19112 3127112
3 Meeting(s) (a) $75.00 each $225.00 March 201
To be paid from
PO (if applicable) N/A
Budget account GL# 1125 -1 -01- 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): yO AhLLlnmt
Approved by (signature of Division Manager):
on this date
Form revised 7 -7 -08 Shared Administrative Forms 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.
Terms_
363779 Kirsh,Joshua
220 2nd Ave., NE
Carmel, IN 46032
Invoice Invoice Description PO Amount
Date Number (or note attached invoice(s) or bill(s)) 225.00
4/3/12 Mar'12 Monthly pay for meetings attended
Total 225.00
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.
363779 Kirsh, Joshua Allowed 20_
220 2nd Ave., NE
Carmel, IN 46032
In Sum of
225.00
ON ACCOUNT OF APPROPRIATION FOR
101 General Fund
PO# or INVOICE NO. ACCT #/TITL AMOUNT Board Members
Dept ept
1125 Mar'12 4341999 225.00 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
5-Apr 2012
Signature
225.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund