259241 05/31/16 y u<<4�qy
J`! '• CITY OF CARMEL, INDIANA VENDOR: 355549
j; ® ONE CIVIC SQUARE Y M C A CHECK AMOUNT: $*******182.25*
=9 ,�� CARMEL, INDIANA 46032 615 N ALABAMA ST SUITE 200 CHECK NUMBER. 259241
''��TO'N�°' INDIANAPOLIS IN 46204-1359 CHECK DATE: 05/31/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
301 5023990 152416 182.25 OTHER EXPENSES
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
YMCA ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
615 N ALABAMA ST SUITE 200 IN SUM OF$ CITY OF CARMEL
An invoice or bill to be properly itemized must show:kind of service,where performed,dates service
INDIANAPOLIS, IN 46204-1359 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
$182.25 Payee
ON ACCOUNT OF APPROPRIATION FOR Purchase Order#
301 Medical Fund Terms
Date Due
PO# ACCT# DATE INVOICE# DESCRIPTION
DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT
152416 50-239.90 $182.25 1 hereby certify that the attached invoice(s),or 5/10/16 152416 $182.25
301 301 301 301
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
Monday, May 16,2016
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
Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer
TM
YMCA of Greater Indianapolis 5/10/2016
615 N Alabama St Suite 200
the Indianapolis IN 46204-1359 Invoice No. _
�vQ (317)266-9622 fax: (317)266-2845 152416
INVOICE
Bill to: City of Carmel 317-571-5850
Attn: J. Spelbring Submitted To
Human Resources, 1 Civic Square
k Carmel, IN 46032 MAY 16 2016
s YMCA membership fees for the month of
April 2016 C;1' a
Name YMCA# Employee Employer Type Date of Birth Remarks
F
Akers, Bill 15-23800 0.00 12.60 Adult HH (2) 03/26/1964
Brisco, Michael 15-36029 0.00 12.60 Adult HH (2) 04/16/1969
Carpenter, David 08-225343 0.00 12.60 Adult HH (2) 07/21/1979
r Dorsch, Jim 15-35796 0.00 12.60 Adult HH (2) 08/04/1969
i Ellison, Chris 01-59211 0.00 12.60 Adult HH (2) 10/14/1974
Gates, John 15-739509 0.00 10.35 Adult(2) Only 07/01/1948
Giles, Greg 15.00 0.00 10.50 Adult HH (1)
Gugel, Mark 15.00 0.00 12.60 Adult HH (2)
Klitzing, Michael 20-131827 0.00 12.60 Adult HH (2) 11/17/1970
S McManama, Carol 12-119123 0.00 7.50 Senior Adult 08/09/1947
McNair, Harland 15-35476 0.00 12.60 Adult HH (2) 12/16/1971
t Mowery, Susan 15-1194 0.00 7.65 Adult 04/21/1958
Ransford, Brett 15-4888 0.00 12.60 Adult HH (2) 10/19/1963
Reeves, Neil 15-608308 0.00 12.60 Adult HH (2) 06/11/1979
Schlaegel, Courtney 15-202628 0.00 7.65 Adult 06/15/1980
A
Watts, Trent 15-233187 0.00 12.60 Adult HH (2) 09/06/1972
Subtotals 0.00 182.25
a
iI
i
y.
16 employees Total Due $182.25
4 '
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:
Q
p' None
Cancellations this period:
Decrastos, Richard 15.00 0.00 10.35 Adult(2) Only Cancelled