208766 05/10/2012 CITY OF CARMEL, INDIANA VENDOR: 363779 Page 1 of 1
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0 ONE CIVIC SQUARE JOSHUA ALBERT KIRSH CHECK AMOUNT: $150.00
CARMEL, INDIANA 46032 2202ND AVE NE
CARMEL IA 46032 CHECK NUMBER: 208766
CHECK DATE: 5/10/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4341999 150.00 OTHER PROFESSIONAL FE
Carme e Clay
Parks &Recreation CHECK REQUEST
1 7 1- ro,
Date: 5/1/2012 IIIA L 0 1 2012
y 5 -9
Check payable to :3,
Name: Joshua Kirsh CCPR BOARD MEMBER
Address: 2202 d Ave. NE
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 4/11/12,4/24/12
2 Meeting(s) $75.00 each $150.00 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): Paula Schlemmer
Requested by (signature):
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)
1
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.
363779 Kirsh, Joshua Terms
220 2nd Ave., NE
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 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
20_
Clerk- Treasurer
Voucher No. Warrant No.
363779 Kirsh, Joshua Allowed 20
220 2nd Ave., NE
Carmel, IN 46032
In Sum of
150.00
ON ACCOUNT OF APPROPRIATION FOR
101 -General Fund
PO# or INVOICE NO. CCT #fTITLE AMOUNT Board Members
Dept
1125 Apr'12 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
3 -May 2012
Signature
150.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund