HomeMy WebLinkAbout208645 05/10/2012 CITY OF CARMEL, INDIANA VENDOR: 365007 Page 1 of 1
ONE CIVIC SQUARE DONNA MARIE CIHAK HANSEN
CARMEL, INDIANA 46032 12122 ELLINGWOOD DR CHECK AMOUNT: $300.00
CARMEL IN 46032 CHECK NUMBER: 208645
«ON
CHECK DATE: 5/10/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4341999 APR'12 300.00 OTHER PROFESSIONAL FE
Carme
Parks &Recreataion CHECK REQUEST
Date: 5/1/2012 T 17 77 WI
SAY 017012
r
Check payable to By: J
Name: Donna Cihak Hansen CCPR BOARD MEMBER
Address: 12122 Ellingwood Drive
City, State, Zip Carmel IN 46032
X Mai{ check to payee Return check to requestor
Check Amount 300.00 Date Required ASAP
Check needed for Monthly pay for meetings attended 4/10/12,4/11/12,4/21/12,4/24/12
4 Meeting(s) CcD $75.00 each 300.00 April 2012
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): Pau la Schlemmer ,CyN
Requested by (signature): ?'YZ�rI Ufa
Approved by (signature of Division Manager):
on this date /n2
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.
365007 Cihak Hansen, Donna Terms
12122 Ellingwood Drive
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
5/1/12 Apr'12 Monthly pay for meetings attended 300.00
Total 300.00
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.
365007 Cihak Hansen, Donna Allowed 20
12122 Ellingwood Drive
Carmel, IN 46032
In Sum of
300.00
ON ACCOUNT OF APPROPRIATION FOR
101 General Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1125 Apr'12 4341999 300.00 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 -May 2012
Signature
300.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund