321065 01/25/18 CITY OF CARMEL, INDIANA VENDOR: 360074
'i•` ONE CIVIC SQUARE SUE WOLFGANG CHECK AMOUNT: $********88.40*
=a CARMEL, INDIANA 46032 C/O HUMAN RESOURCES CHECK NUMBER: 321065
ONE CIVIC SO CHECK DATE: 01/25/18
CARMEL IN 46032
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
301 5023990 01.17.18 88.40 OTHER EXPENSES
�i�
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
Vendor# 360074 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
SUE WOLFGANG IN SUM OF$ CITY OF CARMEL
C/O HUMAN RESOURCES An invoice or bill to be properly itemized must show:kind of service,where performed,dates service
ONE CIVIC SQ rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
CARMEL, IN 46032
Payee
$88.40
ON ACCOUNT OF APPROPRIATION FOR Purchase Order#
301 Medical Fund Terms
301 Medical Fund Date Due
PO# ACCT# DATE INVOICE# DESCRIPTION
DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT
01.17.18 50-239.90 $88.40 1 hereby certify that the attached invoice(s),or 1/17/18 01.17.18 Weight WatchersSession 3 Fee $88.40
301 301 301 301 Reimbursement
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
Thursday,January 18,2018
Lamb, Barbara
Director
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.
tt
OT' ", EL
JAMES BRAINARD, MAYOR
January 17, 2018
PAYEE: SUE WOLFGANG (Please return check to Sue Wolfgang)
AMOUNT: $88.40
SOURCE: 301-391000
REASON: WELLNESS PROGRAM - FEE REIMBURSEMENT
FOR WEIGHT WATCHERS PROGRAM - SESSION 3
tS JAN 17 2018 �
DEPARTMENT OF HUMAN RESOURCES, ONE CIVIC SQUARE, CARMEL, IN 46032
OFFICE 317.571.2465, FAx 317.571.2409