218817 04/09/2013 CITY OF CARMEL, INDIANA VENDOR: 00350721 Page 1 of 1
ONE CIVIC SQUARE LEO DIERCKMAN
' CARMEL, INDIANA 46032 13316 KICKAP00 TRAIL CHECK AMOUNT: $300.00
CARMEL IN 46033 CHECK NUMBER: 218817
CHECK DATE: 4/9/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1192 4343004 300 . 00 TRAVEL PER DIEMS
Stewart, Lisa M
From: Tingley, Connie S
Sent: Tuesday, March 26, 2013 9:01 AM
To: Stewart, Lisa M
Subject: BZA Claims
BZA Claims for first quarter:
Leo Dierckman-$300-Jan 29, Feb 25,-Mar-19,-Mar -
James Hawkins $300 Jan 29, Feb 25, Mar 19, Mar 25 V
Earlene Plavchak $225 Jan 29, Mar 19, Mar 25 v
Alan Potasnik $225 Jan 29, Feb 25, Mar 19
Ephraim Wilfong $300 Jan 29, Feb 25, Mar 19, Mar 25 :.-
Nick Kestner $75 Mar 25 Alternate -
Hal Espey worked Jan 29, Feb 25 and Mar 25
Thanks,
Connie
1
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))
03/26/13 I BZA Meetings I $300.00
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.
ALLOWED 20
Leo Dierckman
IN SUM OF $
13316 Kickapoo Trail
Carmel, IN 46033
$300.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel DOCS
PO#/Dept. INVOICE NO. I ACCT#/TITLE AMOUNT Board Members
I hereby certify that the attached invoice(s), or
1192 I 43-430.04 I $300.00
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
'^ Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund