213631 10/09/2012 CITY OF CARMEL, INDIANA VENDOR: 360379 Page 1 of 1
0 ONE CIVIC SQUARE RECREATION THERAPISTS OF INDIANAIJHECK AMOUNT: $105.00
;4 PO Box 22095 CARMEL, INDIANA 46032
INDIANAPOLIS IN 46222-0095 CHECK NUMBER: 213631
CHECK DATE: 10/912012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1091 4357004 331 105 . 00 EXTERNAL INSTRUCT FEE
i
012
Recreation Therapists of Indiana, Inc. FSEP 2 6 2
P.O. Box 22095
Indianapolis, IN 46222-0095
Invoice #00331
Balance due: $105.00 Purchase 02M kr AmQk / 00.4 h ee
Description I/-1-la o- I4 FLIAIC-1ER,
Pay online. P.O.# C 003 P o0
G.L.# 1021- -�L35 700z1
Invoice details Budaet
Balance due $105.00 Line`Descr
Amount $105.00 Purchaser Data
Invoice # 00331 Approval Cate
Date 25 Sep 2012 -
Event registration
2012 RTI Annual Conference (Bradford Woods, Martinsville, IN)
Invoiced to
Brooke Taflinger, Carmel Clay Parks and Recreation
Item A€nount
Registration for "2012 RTI Annual Conference" (01 Nov 2012 8:00 AM - 02 Nov 2012 4:00 PM, Bradford Woods, Martinsville, $105.00
IN), Daily Non Member
Invoice total $105.00
Carmel • Clay
Parks&Recreation CHECK REQUEST ?,7.T
Date: `�- OCT 0 12012
Check payable to:
Name:
Address: �• d • � :� � J
City, State, Zip1�A ��S.
a
Mail check to payee Return check to requestor
Check Amount: $ VS Date Required:
Check needed for: Cff��Ts-w Tep-
To be paid from:
PO#(if applicable)
Budget account-GL#
Budget Line Description
Invoice(s)and Purchase Order(if required) MUST be attached. _
Requested by(print):
Requested by(signature):
Approved by(signature of Division Manager)<��600.,c..'-0-6.
on this date P'(2--I i(2
Form revised 7-7-08 Shared/Forms/Business Services/Check Request Form/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.
Recreation Therapists of Indiana, Inc. Terms
P.O. Box 22095
Indianapolis, IN 46222-0095
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
9125/12 331 RTI annual conference B.Taflin er $ 105.00
Total--F$ 105.00
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.
i
Recreation Therapists of Indiana, Inc. ; Allowed 20
P.O. Box 22095 i
Indianapolis, IN 46222-0095
In Sum of$
$ 105.00
ON ACCOUNT OF APPROPRIATION FOR
109 - Monon Center
PO#or INVOICE NO. A.CCT#/TITLE AMOUNT Board Members
Dept#
1091 331 4357004 $ 105.00 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
i
4-Oct 2012
X�jRowm�—
Signature
$ 105.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund