221670 07/02/2013 CITY OF CARMEL, INDIANA VENDOR: 357681 Page 1 of 1
ONE CIVIC SQUARE ALAN POTASNIK
CARMEL, INDIANA 46032 12482 CHARING CROSS CHECK AMOUNT: $750.00
A CARMEL IN 46033
„o CHECK NUMBER: 221670
CHECK DATE: 7/2/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1192 4343004 750 . 00 TRAVEL PER DIEMS
Stewart, Lisa M
From: Tingley, Connie S
Sent: Tuesday, June 25, 2013 11:12 AM
To: Stewart, Lisa M
Subject: BZA claims
Second quarter BZA claims:
VzLeo Dierckman $225 (Apr 22, May 28,June 24)
V-'J'ames Hawkins $225 (Apr 22, May 28,June 24)
V"Earlene Plavchak $300 (Apr 22, May 7 Special, May 28,June 24)
Alan Potasnik $225 (Apr 22, May 28,June 24)
Vi5'phraim Wilfong $150 (Apr 22, May 28)
Hal Espey attended the three regular meetings(Apr 22, May 28,June 24).
Please let me know if you need any further information.
Connie Tingley
1
Quarterly Per Diem Claims
Meeting Dates c=>!
4/16/2013 5/7/2013 5/21/2013 5/29/2013 6/4/2013 6/18/2013 6/29/2013 Total to
April -June--- Plan Committees Plan Exec. Comm
Committees i Plan Committee i Be Paid
Names
Hal Es
pey- Media Tech yes no yes
yes
no no
L/Casati, Michael -
75.00 75.00 75.00 75.00
V Grabow, Brad 75.00 00 75.00 75.00
75. 75.00
Kestner, Nick
Kirsh,Joshua 75.-00- 75.00
75.00 375.00
Lawson, Steve 75.00
V Potasnik, Alan 75.00 75.00 $ 75.00 75.00 75.00
75.00 525.00
Stromquist, Steve 75.00 $ 75.00 75.00 75.00
Westermeier, Susan
Wilfong, Ephraim 75.00 $ 75.00 75.00 --
Rider, Kevin yes no yes
yes
yes no
yes
Hollibaugh, Mike yes yes yes I yes
i yes yes i yes
Mike- BZA Meetings: 4/22/2013 5/28/201
attendance only, Mike not
paid for BZA
— —
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))
06/28/13 2nd qtr BZA meetings $225.00
06/28/13 2nd qtr plan meetings $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
I
VOUCHER NO. WARRANT NO.
ALLOWED 20
Alan Potasnik
IN SUM OF $
12482 Charing Cross Road
Carmel, IN 46033
$750.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel DOCS
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
I
1192 43-430.04 $225.00 1 hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
1192 43-430.04 $525.00
materials or services itemized thereon for
which charge is made were ordered and
received except
Friday, June 28, 2013
ctor
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund