HomeMy WebLinkAbout257251 04/05/16 ;` \1CITY OF CARMEL, INDIANA VENDOR: 360927
ONE CIVIC SQUARE NATL INDEPENDENT HEALTH CLUB AS,4Q SCK AMOUNT: $********99.00*
CARMEL, INDIANA 46032 400 10TH ST NW CHECK NUMBER: 257251
FMiTON NEW BRIGHTON MN 55112 CHECK DATE: 04/05/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1091 4355200 90222 99.00 SUBSCRIPTIONS
Voucher No. Warrant No.
NIHCA Allowed 20
National Independent Health Club Assoc
165 8th Ave - Suite# 1
Granite Falls, MN 56241 In Sum of$
i
$ 99.00 ,
I
6
ON ACCOUNT OF APPROPRIATION FOR
I
109 -Monon Center
1
PO#or Board Members
Dept# INVOICE NO. ACCTXTITL AMOUNT
1091 90222 4355200 $ 99.00 1 hereby certify that the attached invoice(s), or
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
March 30, 2016
1
I
Signature
$ 99.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
I
I
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.
N I HCA Terms
National Independent Health Club Assoc
165 8th Ave- Suite# 1
Granite Falls, MN 56241
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
3/4/16 90222 Initial Membership 5/1/16-4/30/17 xx3475 $ 99.00
Total $ 99.00
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
+I+HCA-Nfatio>� I + ependent Health @ u 7 Association
"GS S3th Acle uite I ''G.inxte Fall's;�YINN 5`6
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(320)722-0084 N info@nihca.org : 1. ��` .-. - • • •
MAR °' Invoice
Bill To
Monon Community Center 314/20:1'6
Kurtis Baumgartner
1195 Central Park Drive East DUe Date 425/2016
Carmel,IN 46032
Fccount# Po_,L X�/-
Quantity Description - Rate Amount
Initial Membership Investment 99:00 99.00
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PAYMENT OPTIONS: � 11rue"
Mail in Check `ACH _Credit Card r Pay Monthly
**Monthly Payment are available! Please call NIHCA at(320) 722-0084 to arrange monthly payments.
ACH(Automated Check) Credit Card(Visa OR Mastercard)
Card Number
Account Holder's Name
Routing Number Expiration Date _ ! _ CVV# _
Name on Card
Account Number
Zip Code _ J _ ` _
I hereby authorize this payment to NIHCA,whi�reeing to the disclosures below.
Signature Date 3 9 Loll.
1.A service fee $20 ill be,charged for any billing errors that are a result of inaccurate billing information information provided by'the client,or payment being declined
due to insuffict ntfunds.
2.By choosing to make a monthly payment,you agree to a l2 consecutive month contract,regardless offacility closing,canceling and/ora change in ownership.
3.NIHCA reserves the right to charge latefees after the due date at the rate of$20 per month.