218748 04/09/2013 �,\*f CITY OF CARMEL, INDIANA VENDOR: 365322 Page 1 of 1
ONE CIVIC SQUARE JOHN W ADAMS
CARMEL, INDIANA 46032 12638 ROYCE COURT CHECK AMOUNT: $525.00
CARMEL IN 46033 CHECK NUMBER: 218748
CHECK DATE: 4/9/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1192 4343004 525 . 00 PER DIEMS
1st Quarter Per Diem
Claims
Meeting Dates j Total to Be
1/15/2013 -I- 2/5/2013 2/19/2013 3/6/2013 j 3/9/2013 j 3/19/2013 3/27/2013 Paid
_ ! -_ Plan Committees i- _Plan I Committees Workshop Plan -ICommitteesl
- I ----------
Names 14
Hal Espey- Media Tech---------'
- ---- �------ n/a - -
I --_ n/a
75:00 n
Adams,-John- 75,00 � � $_
-$ 0 . 750 0 j�-
$=2SQ0?
Casati, Michael 75.00 $
75.00 f $ 75.00 i $ 75.00 $ 75.00 ; $ 75.00 i $ 75.00 $ 525.00
Grabow, Brad 75
{ $ .00 I $ 75.00 $ - 75.00 { _ -
-- -- - -- --- - ------i----- -�_$ 75_00 $ 75.00_f $ - 1 $- 75.00 $ 450.00 ✓
absent- /
Kestner, Nick - - _� $ 75.00 $ - 75.00 i $- 75.00 $ $ -- 75.00 ; $ 75.00 I $ 75.00 j $ 450.00
- ---'--- absent � ------�---
-- -__ -----I--
Kirsh,Joshua __---------- - i ---- ,-------_-- , i .__-._-------- _� --
$---- 75.00 i $ 75.00 75.00 j $ 75.00 ( $ 75.00 $ 75.00 $ 450.00
- -------- ----� -- i absent I --- -i ------;------
Lawson, Steve - --- ( $ - 75.00 $ 75.00 $ 75.00 $ 75.00 j $_ 75.00 $ 75.00 j $ 75.00 $ 525.00
( I -
Potasnik, Alan $ 75.00 j $ 75.00 j $ 75.00 $ 75.00 I $ 75.00 $- 75.00 ; $ 75.00 ! $ 525.00
Stromquist, Steve _ - $ ---- 75.00 75.00 j $ - I $ 75.00 ( $ 75.00 $ - $ 300.00
n/a -I I n/a
i----- --` ; - n/a -i
Westermeier, Susan - 75.00 $ j $ 75.00 { $ 75.00 ( $ 75.00 I $ 75.00 $ 75.00 $ 450.00
absent----1---- -�--- - -- '- -
Wilfong, Ephraim j $ 75.00 ( $ 75.00 $ 75.00 I $ 75.00 j $ 75.00 J $ 75.00 j $ 75.00 j $ 525.00
Prescribed by State Board of Accounts City Form No.201 (Rev.1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or 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
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s)or bill(s))
04/08/13 1 st quarter PC mtgs $525.00
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.
ALLOWED 20
John Adams
IN SUM OF $
12638 Royce Court
Carmel, IN 46033
$525.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel DOCS
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1192 43-430.04 $525.00 I 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
Monday, April 08, 2013
Director
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund