182613 02/17/2010 CITY OF CARMEL, INDIANA VENDOR: 355549 Page 1 of 1
0 ONE CIVIC SQUARE Y M C A CHECK AMOUNT: $235.86
CARMEL, INDIANA 46032 615 N ALABAMA ST SUITE 200
INDIANAPOLIS IN 46204 -1359 CHECK NUMBER: 182613
CHECK DATE: 2/17/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1201 4341980 1234828 235.86 WELLNESS PROGRAM
YMCA of Greater Indianapolis 2i4i2a10
615 N Alabama St Suite 200
Indianapolis IN 46204 -1359 Invoice No. C 1234828
(317) 266 -9622 fax: (317) 266 -2845
INVOICE
i
Bill to: City of Carmel 317 571 -5850
Attm Michele Whittington
Human Resources, 1 Civic Square
Carmel, IN 46032
YMCA membership fees for the month of
February 2010
Name YMCA Employee Employer Type Date of Birth Remarks
Allen, Brad 0.00 10.95 Adult
Baskerville, Anthony 0.00 10.95 Adult HH 2
Baskerville, Steve 0.00 12.18 Adult
Borowicz, Paul 0.00 18.87 Adult HH 2
Brisco, Michael 0.00 10.95 Adult HH 2
Coffey, Tim 0.00 10.95 Adult HH 2
Conn, Angie 0.00 10.95 Adult HH 2
Dorsch, Jim 0.00 10.95 Adult HH 2
Duncan. Gary Jr. 0.00 10.95 Adult HH 2
Ellison, Chris 0.00 10.95 Adult HH 2
i Giles, Greg 1 0.00 10.95 Adult HH 2
I Gu ei, Mark 0.00 14.91 Adult HH 2
Hoffman, Matthew 0.00 7.35 Adult
Huffman, David 0.00 10.95 Adult HH 2
I
Liggett, Brent 0.00 10.95 Adult HH 2
McManama, Carol 0.00 7.35 Adult
McNair Harland 0.00 10.95 Adult HH 2
Ransford, Brett 0.00 10.95 Adult HH 2
Spearman, Ted 0.00 10.95 Adult HH 2
Steele, Jeffrey 0.00 10.95 Adult HH 2
Stindle, Kevin 0.00 10.95 Adult HH 2
Subtotals 0.00 235.86
t
21 employees Total Due $235.86 F
/A F
j
Please remit to:
YMCA of Greater Indianapolis Terms: Net 30 days D q
615 N. Alabama Street
Indianapolis, IN 46204 FEB
D!
i f
By
Page 1
4 l
YMCA membership fees for the month of
February 2010
i
d
Name YMCA Employee Employer Type Date of Birth Remarks
r
E
i Additions this period: I
f Baskerville, Steve 0.00 7.35 Adult lJoined 1 -11 -10
Borowicz, Paul 0.00 10.95 Adult HH 2 Joined 1 -9 -10
Gu el, Mark 0.00 10.95 Adult HH 2 Joined 1 -20 -10
i
Cancellations this period:
Hoiubik, Steve 1 0.00 1 10.95 Aduit HH (2) jOn hold until June
Page 2
VO NO. WARRANT NO.
ALLOWED 20
YMCA of Greater Indianapolis
IN SUM OF
615 N. Alabama St., Suite 200
Indianapolis, IN 46204 -1359
$235.86
ON ACCOUNT OF APPROPRIATION FOR
Carmel HR Department
PO# Dept. INVOICE NO. ACCT #!TITLE AMOUNT Board Members
1201 I 1234828 I 43- 419.80 I $235.86 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
Monday, February 15, 2010
Director, HR
HR
Title
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 Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
02/04/10 1234828 $235.86
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