HomeMy WebLinkAbout251790 11/18/15 y d C,Ab
CITY OF CARMEL, INDIANA VENDOR: 355549
® `l• ONE CIVIC SQUARE Y M C A CHECK AMOUNT: $*******197.70*
r. i' CARMEL, INDIANA 46032 615 N ALABAMA ST SUITE 200 CHECK NUMBER: 251790
,Miro+�O INDIANAPOLIS IN 46204-1359 CHECK DATE: 11/18/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
301 391000 2966930 197.70 HEALTH INSURANCE PREM
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11/3/2015
LV YMCA of Greater Indianapolis
615 N Alabama St Suite 200
jithe Indianapolis IN 46204-1359 Invoice No.
Q- (317) 266-9622 fax: (317) 266-2845 _ _ 2966930
INVOICE
Bill to: City of Carmel 317-571-5850
Attn: J. Spelbring
Human Resources, 1 Civic Square
Carmel, IN 46032 Submitted To
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YMCA membership fees for the month of NOV 16 2015 tl
November 2015
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Name YMCA# Employee Employer Type Date of Birth
Akers, Bill
Subtotals 0.00 1 197.70
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17 employees Total Due $197.70
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Please remit to:
YMCA of Greater Indianapolis Terms: Net 30 days y
615 N.Alabama Street j
h Indianapolis, IN 46204
Please note: Accounts more than 90 days in arrears will be
s assessed a 10% late fee of the total amount due
Additions this period:
" None
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Cancellations this period:
Holubik, Steve 0.00 12.60 Adult HH (2) Cancelled 10-31-15
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VOUCHER NO. WARRANT NO.
ALLOWED 20
YMCA
IN SUM OF$
615 N ALABAMA ST SUITE 200
INDIANAPOLIS, IN 46204-1359
$197.70
ON ACCOUNT OF APPROPRIATION FOR
PO#/Dept. INVOICE NO. ACCT#/Fund AMOUNT Board Members
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2966930 110-100.00 $197.70 1 hereby certify that the attached invoice(s), or
301 301
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
f�Monday, November 16, 2015
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 Date invoice# Description -Amount =
Dept. Fund# (or note attached invoice(s)or bill(s))
11/03/15 2966930 $197.70
301 301
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