186765 06/23/2010 *r CITY OF CARMEL, INDIANA VENDOR: L2367 Page 1 of 1
ONE CIVIC SQUARE CARMEL CLAY PARKS -MONON CENTEF CHECK AMOUNT: $241.30
CARMEL, INDIANA 46032 C/O AUDREY KOSTRZEWA
CHECK NUMBER: 186765
CHECK DATE: 6/2312010
D EPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1201 84341980 19344 241.30 WELLNESS PROGRAM
Clay
Parks& Recreation
Today's Date: jum 17, 2010
ri
City of Carmel
One Civic Square
Carmel, TN 46032
317.1571.5850
INVOICE 06172010
V1,
2(
1 6/18/2010 65/29/"`-jO� 06/11/10 Mernbership Dues $0 1665
Nlake alf checks priyakk io Cai Cla Pirks and
Carmol Clav Pnrks and
Altin: Tara Wooioi v
l 1 E. I INI SI.
Carmel, IN 46032
Thank you f or your participation!
JUN
By�
Name Payroll Membership Employee City Total Due
Effectiv bate Type
B lanchard, Jim 602007 Household 30.00 5.08 35.08 Blanchard James Household $35.OS 0.00
Brant, Kenneth 2/1212 010 Household 30.00 5.08 X35.08 Brant Kenneth Adult, Adult $35.08 0.00
Buhmann, Kev in 7/6/2007 Household 30.00 5.08 35.08 Buhman Kevin Household $35.0 0.00
Burke, Raphael 5/2612010 Household 30.00 5.08 35.08 Burke Raphael Household $35.08 0.00
Campbell, R. Scott 6/812007 Household 30.00 5.08 35.08 Campbell R. Scott Household $35.08 0.00
Carter, Ron 411112008 S 3. 21.43 Carter Ron 21.43 0.00
Cooper, Jeffery Household 30.00 5.08 35.08 Cooper Jeffery Household $35.08 0.00
Collins, Larry 11212009 Household 30.00 5.08 3 08 Collins Larry Household $35.08 0.00
Co Justin 1 Adul 11.08 1.85 1293 C Justin Adult $12.93 0.00
Coy, Sue 618/2067 Household 30.00 6.08 35.08 cm y Susan Household $35.08 0.00
Daley, Penny 5!912008 Household 30.00 5.08 35.08 Daley Penny Household $35.08 0.00
D eitsch, Marc 2/12/2010 Household 30.00 5.08 35.08 Deitsch Marc Househ $35.08 0 .00
Dietz, Aaron 616/2006 Household 30.00 5.08 35.08 Dietz Aaron Household $35.08 0.00
Drake, Carl 519/2008 Adult 11.08 1 -85 12.93 l0rake Carl Adult $12.93 0.00
D uffy, Jo hn 2/12/2 Household 30.00 5.08 35.08 Duffy John Hou sehold $35.0 0.00
Edwards, Dan 3114/2008 Household 30.00 5.08 35.08 Edwards Dan I Household $35.08 0.00
Edwards, Steve 2112/2010 Adult 30.00 5.08 35.08 Edwards Steven Household $35.08 0.00
Essex, Cory 2 /26/20 10 Adult/Adult 22.16 370 25.86 Essex Cory Adu Ault $25.86 0.00
Fag Timoth 7/6/2007 Household 30.00 5.08 35.08 Fagin Timothy Household $35.08 0.00
Force, Jason 5/7/2010 Household 30.00 5.08 135.08 Force Jason Household $35.08 0.00
Gil William 3 11412008 Adult 11.08 1.85 12.93 G Willi Adult $12.93 0.00
Griffin, Tim 911412007 Household 30.00 5.08 35.08 Griffin Tim Household $35.08 0.00
Griffiths, Pam 61812007 Household 30.00 5.08 35.08 Griffiths Pamela Household $35.08 0.00
Hicks, Jeffrey_ 112/2009 AduIVA 2 3.70 25.86 Hicks Je Adult, Adult 25.86 0.00
Holland Greg 2112/2016 Household 22.16 370 25.86 Hollander G
reg Adult, Adult $25.86 0.00
Hollibaugh, Michael 7/6/2007 Household 30.00 5.08 35.06 Hollibaugh Michael Household $35.08 0.00
Hughes, Deborah 111/2009 Household 30.00 5.08 35.08 Hughes Deborah Household $35.08 0.00
Krcmery, Michelle 716/2007 Household 30.00 5.08 35.08 Kfcmery Michelle Household $35.08 0.00
Lafollette, Ga ry 6/8/2007 Adult 1 Adult 22.16 3.70 25.86 LaFollette Gary Adult, Adult $25.86 0.00
Lamb, Barb 1 1 1912 0 07 AdulUAdull 22.16 3.70 25.86 Lamb Barbara Adult/ Adult $25.86 0.00
Locke Robe 6!- 7 Household 30.00 5.08 35.08 _Locke Robert Household $35.08 0.0
Luper, Michael 3/14/2008 Adult 11. 08 1.85 12.93 Luper II Michael Adult $12.93 0.00
Martin, Candy 3/1/2009 Adult 11.08 1.85 12.93 Martin Candy A dult $1 2.93 0.0
Mascari, John 1 011 212 0 07 Adult 11.08 1.85 12.93 Mascari John A $12.93 0.00
dult
Massin Rand 9/1212008 Adult 11.08 1.85 12.93 Massingill Randy Adult $12.93 0.00
Mast, D arr en 71 Adult 11.08 1.85 12 .93 M as t Darre Adu $12.93 0.00
McNab, John 112/2009 Adult 11.08 1.85 12.93 MCNab John Adult $12.93 0.00
Me yer, Amanda 6/812007 AdulUAdult 22.16 170 25.86 Me yer Amanda Adult, Adult $25.86 0.00
Mi ller, A dam 71612007 Adult/Youth 18.00 3.43 21.43 Miller Adam Adult/ $21.4 0.00
Miller, Ken 4/23/2070 SeniorlAdult 18.00 3.43 21.43 Miller Ken SeniorlAdult $21.43 0.00
Mor gan, Trent 1/15/2010 Adult 11.08 1.85 12 -93 Mor gan Trent Adult $12.93 0.00
Myers, Brady 12/112008 Household 30.00 5.0 35.08 Myers _8 Brady House $35.08 0.00
Neville, Katie 1!1512010 Adult 11.08 1.85 12.93 Neville _Katie Adult $12.93 0.00
Nicel Wes 12/5/2008 Adult 11.08 1.85 12.93 Nicee Wes Adult $12.93 0.00
Ora Dou 101 10!2008 A_dult 11.08_ 1.85 12.93 _Orange Dou9 _Adult w- $12.93 0.00
Paddock, Ronald 5/26/2010 Adult 11.08 1.35 12.93 Paddock Ronald Adult $12.93 0.00
Pattyn, pawn 6/8/2007 Household 30.00 5.08 35.08 Pattyn Dawn Household $35.08 0.00
Pitman, Michael 2/12/2010 Household 30.00 5.08 35.08 pitman Michael Household $3 0.00
Adult
Platt, Ace 618!2007 Adult 11.08 1.85 12.93 Platt Jace Adult $12.93 0.00
Price, Joe 1211812009 Household 30.00 5.08 35.08 Price Joseph Household $35.08 0.00
Rho Ke nneth 618/2007 Adult/Adult 22.16 3.70 25.86 Rhodes Kenneth Adult, Adult $25 0.00
Rider, Kevin 211!2008 AdulUAdult 22.16 3.70 25.86 Rider Kevin Adult, Adult $25.86 0.00
Schriner, Adam 11212009 lAdult/Adult 22.16 3.70 25.86 Schriner Adam Adult, Adult $25.86 0.00
Sharp, Rick 101 V2 008 Household 30.00 5.08 35.08 Sharp Rick Hous $35.08 0.00
ouseh ld 8
Smith, Jer ry 2/1/2008 Household 30.00 5.08 35.08 Smile Landry Household $35.08 0.00
Smile Land 1 /1512010 Household 30-60 5.08 3 5.08 Smith Jerry Household $35.08 0.00
Steury, Kent 3(112009 Adult 1 1-68 1.85 12.93_ Steury Kent Ad 12.93
Thomas, John 713/2008 AduIt u It 22.16 3.7 25.86 Thomas John Adult, Adult $25.86 0.00
Tierne Scott 618/2007 Household 30.00 5.08 35.08 Tierney Scott Household $35.08 0.00
Utzi Chad 61812 H 30.00 5.08 35.08 Utzig Chad H ou s eh old $35.08 0.00
White, Robert 519!2008 Household 30.00 5.68 35.08 White Robert Household $35.08
Whitlow, Sean 5/2212009 Adult 11.08 1.85 12.93 Whitlow Sean Adult $12.93 0.00
Total Monthly Bill .$1 fi65 26 -1
11423.96 241.30 1665.26 H
SUNGARD PENTAMATION, INC. PAGE NUMBER: 235
DATE: 06/16/2010 CITY OF CARMEL MODULE NUM: PAYCHK43
TIME: 12:25:15 DEDUCTION REGISTER CHECK DATE 06/18/2010
PAY RUN 12 PR 1012
361 MONON CENTER PAYROLL DRD
EMPLOYEE EMPLOYER
EMPLOYEE EMPLOYEE NAME---- SUBJECT WAGES ACCOUNT DEPARTMENT DEDUCTION CONTRIBUTION ARREARS
120 BLANCHARD JAMES
1192 22 "16 .00 .00
SUNGARD PENTAMATION, INC. PAGE NUMBER: 236
DATE: 06/16/2010 CITY OF CARMEL MODULE NUM: PAYCHK43
TIME: 12:25:15 DEDUCTION REGISTER CHECK DATE 06/18/2010
PAY RUN 12 PR 1012
361 MONON CENTER PAYROLL DED
EMPLOYEE EMPLOYER
EMPLOYEE EMPLOYEE NAME---- SUBJECT WAGES ACCOUNT DEPARTMENT DEDUCTION CONTRIBUTION ARREARS
2140 SHARP RICHARD
1,423.96 .00 _00
VOU CHER NO. WA N O.
ALLOWED 20
Carrhel Clay Parks and Recreation Monon Ce
c/o Audrey Kostrzewa IN SUM OF
1411 E. 116th St.
Carmel, IN 46032
$241.30
ON ACCOUNT OF APPROPRIATION FOR
Carmel HR Department
PO# Dept. INVOICE NO, ACCT #!TITLE AMOUNT Board Members
19344 I 06172010 I 43-419.801 $241.30 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
Friday, June 18, 2010
Director, 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))
06/17/10 06172010 $241.30
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