245326 5 /13/2015 4{pf tqq��
CITY OF CARMEL, INDIANA VENDOR: 355549
ONE CIVIC SQUARE Y M C A CHECK AMOUNT: $***'***222.30•
CARMEL, INDIANA 46032 615 N ALABAMA ST SUITE 200 CHECK NUMBER: 245326
INDIANAPOLIS IN 46204-1359 CHECK DATE: 05/13/15
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DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
301 5023990 2802991 222.30 OTHER EXPENSES
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5/5/2015
YMCA of Greater Indianapolis
615 N Alabama St Suite 200
,the Indianapolis IN 46204-1359 Invoice No. _ �l
�Q (317) 266-9622 fax: (317) 266-2845 2802991 1
L �� INVOICE
j
Bill to: City of Carmel 317-571-5850
Attn: J. Spelbring
Human Resources, 1 Civic Square
Carmel, IN 46032 FSubmitted To
YMCA membership fees for the month of 1 1 2015
May 2015
k
Clerk Treasurer
Name YMCA# Employee Employer Type Date of Birth Nui i i0i NOI
Akers, Bill
i
Subtotals 0.00 222.30
19 employees Total Due $222.30
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
i Additions this period:
i'
None
Cancellations this period:
Hernandez, Jesus 0.00 12.60 Adult HH (2) Cancelled 4-30-15
' I -
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City FonnNo.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
YMG A Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
05/05/15 2802991 Monthly membership -May 2015 _ $222.30
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
20Clerk-Treasurer
VOUCHER NO. WARRANT NO.
05/05/15
ALLOWED 20
YMCA of Greater Indianapolis
IN SUM OF $
615 N. Alabama Street, Ste 200
Indianapolis, IN 46204-1432
$ $222.30
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
2802991 301 222. 0 the materials or services itemized thereon
for which charge is made were ordered and
received except
20
Signature / 2
r. c s - `
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund