227258 12/17/2013 aai��QMF CITY OF CARMEL, INDIANA VENDOR: 365322 Page 1 of 1
ONE CIVIC SQUARE JOHN W ADAMS CHECK AMOUNT: $450.00
CARMEL, INDIANA 46032 12638 ROYCE COURT
CARMEL IN 46033
CHECK NUMBER: 227258
CHECK DATE: 12/17/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1192 4343004 450 . 00 PER DIEMS
Quarterly Per Diem Claims
Meeting Dates M41 10/1/2013 10/14/2013 10/15/2013 11/5/2013 11/19/2013 12/3/2013 12/17/2013 Total to
Oct- Dec Comm Silvara Plan Comm Plan Comm Plan Be Paid
Names 07
Hal Espey- Media Tech no no yes no yes no yes
I
Adams,John W. $ 75.00 $ 75.00 $ 75.00 $ - $ 75.00 $ 75.00 $ 75.00 $ 450.00 4/
Casati, Michael $ 75.00 $ - $ 75.00 $ 75.00 $ 75.00 $ 75.00 $ 75.00 $ 450.00
Grabow, Brad $ 75.00 $ 75.00 $ 75.00 $ - $ 75.00 $ 75.00 $ 75.00 $ 450.00 ,
Kestner, Nick $ 75.00 $ - $ - $ - $ 75.00 $ 75.00 $ 75.00 $ 300.00
Kirsh,Joshua $ - $ 75.00 .$ 75.00 $ - $ 75.00 $ 75.00 $ 75.00 $ 375.00
Lawson,Steve $ 75.00 $ - $ 75.00 $ 75.00 $ 75.00 $ 75.00 $ 75.00 $ 450.00
I
Lockwood, Dennis $ 75.00 $ 75.00 $ 75.00 $ - $ 75.00 $ 75.00 $ 75.00 $ 450.00
I
Potasnik,Alan $ - $ - $ 75.00 $ - $ - $ 75.00 $ 75.00 $ 225.00
Stromquist,Steve $ - $ - $ 75.00 $ - $ 75.00 $ - $ 75.00 $ 225.00
Westermeier, Susan $ 75.00 $ - $ 75.00 $ 75.00 $ 75.00 $ 75.00 $ - $ 375.00
Rider, Kevin yes yes yes yes yes yes
Hollibaugh, Mike yes yes yes no yes yes
VOUCHER NO. WARRANT NO.
ALLOWED 20
John Adams
IN SUM OF $
12638 Royce Court
Carmel, IN 46033
$450.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel DOCS
PO#/Dept. INVOICE NO. I ACCT#!TITLE AMOUNT Board Members
1192 43-430.04 $450.00
I hereby certify that the attached invoice(s), or
I
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
Friday, Dec7mbar 13, 201
Direc r
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
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))
12/12/13 3rd quarter per diems $450.00
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