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245113 05/13/15 +pi.CAgM ,�. CITY OF CARMEL, INDIANA VENDOR: 367453 ;- ® „• ONE CIVIC SQUARE MARY EVANS CHECK AMOUNT: $***""**"53.42" ?a CARMEL, INDIANA 46032 14831 BIXBY DRIVE CHECK NUMBER: 245113 WESTFIELD IN 46074 CHECK DATE: 05/13/15 1,y/l SON L-0. DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1091 4343000 13.42 TRAVEL FEES & EXPENSE 1091 4357004 40.00 EXTERNAL INSTRUCT FEE Carmel • Clay Parks&Recre ation rAPR 2 8 2015 Employee Expense Reimbursement Request Date of Fund Account Account Receipt Vendor listed on receipt # Line# Budget Description Amount Purpose of Expense l ct( 6/0Jc s a foe/( Y3`( o '144 o3 4G)UPTIL' FI'Thess All receipts should be attached in the same order as listed above. No L No sales tax will be reimbursed. TOTAL: $0.001 Employee Name(print) QnS Address iC' - Check payable to: City, St,Zip Signature: Approved by: /--/,z r � f Date: Date: Business Services Division,Revised 7-7-08 FILE: Shared\Forms\Business Services\Employee Exp Reimb Request i Order#47625 https://hes-ssequip.healthways.com Date:Tuesday,April 21,2015 Billing Information: Name:Mary Evans Phone: Address: 14831 Bixby Drive Westfield,Indiana 46074 United States Payment method:CRESecure Product(s) r r � �t 1� ws2._ � �` e,yr�i,�.;"fw`" '�!.�'���x'� h� � �fi; vs�"°fi"'"a�,i' ; ""y';�x�k�a�i 1�'�, �ie �� M�„�!lk5 e � �,ak�'� � `�e'�� r,4 c .. � 14,1 s. ' +` �r .�;fi�1t'N,"s',:miY :.'trI�rleeM 1•,�it ..,sri ..h Qty. H r,:. .,.�,, w:r'. l oTotal. $40.00 I $40.00 Classic-2015 Sub-total:$40.00 Tax:$0.00 Order total:$40.00 i I ly t a i T, �, C IAr s3 400 ; 1p•;:1 t t rfi r au i ! � 4 yx '�€n vV �. � C2 vt � �.�\ t n,to oSst a� r ura w�� s. r' cV 'Gr� v4� , � � U F HealthWars .. 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'Y.`.,1`nn- sr,:»,.},,;�r vxs..:.,:_1?„ ,,:Y,.\...., "1,,.3,-..-J.;.,, .,. .,f. . .,,*, ..u,... ,Y�r:,,-..n9�, r.. , . :�:"wrww�� .� 1 i 1 Classic - 2015 1 Course Name 1 i Mary L Evans Kymberli D Nix } Participant Name(please print) Course Trainer i 1 North Manchester/IN 4/24/2015 i �Ce_ttficatt© z V id664 `:l OYakneet xt Program Date Program Location(City/State) 3 t ,T �,j,.--! nt e it t escra Ss . t Y C 7 s } 1 ; ACE :P E a CEPO9.724 z f7'��Oi2O =i 1 `` 1 Y` �5,4, 77,a i,< 4 � `\ 5' Strauss-Peabody Aquatic and Fitness Center 1 E AFAR 12f31 f `f 2 00 { T___ ______-`------__._--` __ _ , _ ' y Program Facility Name i v TEea wcvyk inc./. `o1F Provider Provider Name Signature i 1 i This course has been approved byAFAA for continuing education units,but was not developed byAFAA.Therefore it does not count as an AFAA course which is required for recertification,) 424 SSFPNAT-385 9.11 - Instructor Resource Center Page 1 of 1 t : Instructor Resource Center Find a Workshop Purchase Shopping Cart My Purchases Return to a Voucher Learning Center Classic-2015 Start Date 4/24/2015 ' ApR 2---g 2615 Start Time 10:00 AM Length 120 Minutes Y. Instructor •Name Kymberli Nix Venue Name Strauss-Peabody Aquatic and Fitness Center Address 902 N.Market St North Manchester,IN 46962 Learn custom designed exercises taught in the SilverSneakers Group Exercise Program to improve agility,balance,coordination and activities for daily living(ADLs)by increasing muscular strength and range of Course movement.INCLUDED:Healthways Core Knowledge online module(45 Description minutes),Fraud,Waste,and Abuse(10 minutes),SilverSneakers Basics online module(45 minutes),Classic online module(20 minutes)and the Classic in-person workshop(2 hours)'Completion of online coursework is required Available 15 Spots Price $40.00 j Add To Shopping_Cart_a 1.�Q Back_d Copyright©2015 Healthways,Inc.-All rights reserved. CC� https://hes-ssequip.healthways.com/S SEquipment/WorkshopShoppingCart/showDetail?id=... 4/20/2015 Mary Evans From: Mary Evans <mlmethod@aol.com> Sent: Wednesday,April 22, 2015 6:59 AM To: Mary Evans ' Subject: Fwd:Workshop Order Completed Follow Up Flag: Follow up Flag Status: Flagged Mary Evans mlmethod@aol.com Begin forwarded message: APR 2 From: <DONOTREPLY(a_healthways.com> =- Subject: Workshop Order Completed Date: April 22, 2015 at 6:53:35 AM EDT To: <mlmethod(a)-aol.com> I, Order Number: 47625 Course Name: Classic-2015 Start Date: 4/24/2015 Start Time: 10:00 AM Length: 02:00:00 Venue Name: Strauss-Peabody Aquatic and Fitness Center Address: 902 N. Market St Instructor Name: Kymberli Nix Trainer Email: kymberliiiix@gmail.com Order Summary N>ame Price !:uant E Tot 1 Classic- 2015 $40.00 1 $40.0 Sub=Total: $40..1 Tax: $0.1 Order Total: $40.1 1 Mary Evans From: Mary Evans <mlmethod@aol.com> Sent: Wednesday,April 22, 2015 6:59 AM To: Mary Evans Subject: Fwd:Workshop Order Completed Follow Up Flag: Follow up Flag Status: Flagged Mary Evans mlmethod@aol.com Begin forwarded message: APR 2 8 2615 From: <DONOTREPLY(c_healthways.com> � = Subject: Workshop Order Completed - Date: April 22, 2015 at 6:53:35 AM EDT To: <mlmethod(a)_aol.com> Order Number: 47625 Course Name: Classic - 2015 Start Date: 4/24/2015 Start Time: 10:00 AM Length: 02:00:00 Venue.Name: Strauss-Peabody Aquatic and Fitness Center Address: 902 N. Market St Instructor Name: Kymberli Nix Trainer Email:kymberlinixggmail.com Order Summary F_ Name �� Price � � Quantity � Total i Classic-2015 $40.00 1 $40.0 Sub-Total: $40.1 - Tax: $0.1 Order Total:: $40.1 1 This email contains confidential and proprietary information and is not to be used or disclosed to anyone other than the named recipient of this email,and is to be used only for the intended purpose of this communication. 2 ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice of 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. 367453 Evans, Mary Terms 14831 Bixby Drive Westfield, IN 46074 Invoice Invoice Description Date Number (or note attached invoice(s)or bill(s)) PO# Amount 4/24/15 Reimb. Travel expenses for Aquatic&Fitness Workshop $ 40.00 4/24/15 Reimb Travel expenses for Aquatic&Fitness Workshop $ 13.42 Total $ 53.42 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. 367453 Evans, Mary Allowed 20 14831 Bixby Drive Westfield, IN 46074 In Sum of$ $ 53.42 t ON ACCOUNT OF APPROPRIATION FOR 109 -Monon Center PO#or INVOICE NO. ACCT#1TITLIE AMOUNT C Board Members Dept# r 1091 Reimb 4357004 $ 40.00 1 hereby certify that the attached invoice(s), or 1091 Reimb 4343000 $ 13.42 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 i i May 7,2015 Signature $ 53.42 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund 1;-