190056 09/14/2010 CITY OF CARMEL, INDIANA VENDOR: 355549 Page 1 of 1
ONE CIVIC SQUARE Y M C A
CARMEL, INDIANA 46032 615 N ALABAMA ST SUITE 200 CHECK AMOUNT: $241.05
INDIANAPOLIS IN 46204 -1359 CHECK NUMBER: 190056
CHECK DATE: 9/14/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1201 R4341980 19344 1374239 241.05 WELLNESS PROGRAM
k r
TM
YMCA of Greater Indianapolis 9/3/2010
615 N Alabama St Suite 200
1 Indianapolis IN 46204 -1359 Invoice No. 1374239
(317) 266 -9622 fax: (317) 266 -2845
INVOICE
Bill to: City of Carmel 317 571 -5850
Attn: Michele Whittington
Human Resources, 1 Civic Square
Carmel, IN 46032
YMCA membership fees for the month of
September 2010
Name YMCA Employee Employer Type Date of Birth Remarks
Allen, Brad
Subtotals 0.00 1 241.05
23 employees Total Due $241.05
Please remit to:
YMCA of Greater Indianapolis Terms: N 30 days SEP 13 2010
615 N. Alabama Street
Indianapolis, IN 46204
By
Pagel
f•
YMCA membership fees for the month of
September 2010
Name YMCA Employee Employer Type Date of Birth Remarks
Additions this period:
None
Cancellations this period:
None
i
Page 2
VOUCHER NO. WARRANT NO.
ALLOWED 20
YMCA of Greater Indianapolis
IN SUM OF
615 N. Alabama St., Suite 200
Indianapolis, IN 46204 -1359
$241.05
ON ACCOUNT OF APPROPRIATION FOR
Carmel HR Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
19344 1374239 43- 419.80 I $241.05 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, September 13, 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 Nu mber (or note attached invoice(s) or bill(s))
09/03/10 1374239 $241.05
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