242440 02/17/15 •_Cqq
CITY OF CARMEL, INDIANA VENDOR: 355549
,3 d a ' ONE CIVIC SQUARE Y M C A CHECK AMOUNT: $ .....232.80*
:. =a CARMEL, INDIANA 46032 615 N ALABAMA ST SUITE 200 CHECK NUMBER: 242440
>M(run L4. INDIANAPOLIS IN 46204-1359 CHECK DATE: 02/17/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
301 5023990 2719048 232.80 OTHER EXPENSES
TM
VIEW
2/4/2015
YMCA of Greater Indianapolis
615 N Alabama St Suite 200 '!
��� _ Invoice No.
Q Indianapolis IN 46204-1359 _ _
V (317) 266-9622 fax: (317) 266-2845 2719048
INVOICE
Bill to: City of Carmel 1,7-57.1,-585.0,_;., _
Attn: J. Spelbring
Human Resources, 1 Civic Square !
Carmel, IN 46032
FEB 16 2015
YMCA membership fees for the n nth of
February 2015 Clerk Treasurer
_ r
r
Name YMCA# Employee Employer Type Date of Birth Remarks
Akers, Bill
�i
Subtotals 0.00 232.80
i
Page 1
YMCA membership fees for the month of `
February 2015
Name YMCA# Employee Employer Type Date of Birth Remarks
20 employees Total Due F $232.80
Please remit to:
YMCA of Greater Indianapolis Terms: Net 30 days
615 N. Alabama Street
Indianapolis, IN 46204
Please note: Accounts more than 90 days in arrears will be
assessed a 10% late fee of the total amount due
Additions this period:
None
Cancellations this period:
Carpenter, Jeffery 20-545170 0.00 12.60 Adult HH (2) 03/26/1958 Cancelled 1-31-15
Myers, Felicia 12-677799 0.00 12.60 Adult HH (2) 1 07/25/1983 ICancelled 1-31-15
Page 2
r
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No.201(Rev.1995)
- 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
YMCA
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
0210.4115 9048 Monthly membership -Feb 2015
Total
I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accor-
dance with IC 5-11-10-1.6.
, 20
Clerk-Treasurer
VOUCHER �Q,�1.5_WARRANT NO.
[[
YMCA of Greater Indianapolis ALLOWED 20
IN SUM OF $
615 N. Alabama Street, Ste 200
Indianapolis, 46204-1432
$ $232.80
ON ACCOUNT OF APPROPRIATION FOR
301 MEDICAL FUND
Board Members
PO#or INVOICE NO. ACCT#/TITLE AMOUNT
DEPT.# I hereby certify that the attached invoice(s),
or bill(s) is (are) true and correct and that
2719048 301 $232.80 the materials or services itemized thereon
for which charge is made were ordered and
received except
20
Signature
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund