191890 11/10/2010 CITY OF CARMEL, INDIANA VENDOR: 355549 Page 1 of 1
ONE CIVIC SQUARE YMCA CHECK AMOUNT: $220.50
CARMEL, INDIANA 46032 615 N ALABAMA ST SUITE 200
INDIANAPOLIS IN 46204 -1359 CHECK NUMBER: 191890
CHECK DATE: 11/10/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1201 R4341980 19344 1411635 220.50 WELLNESS PROGRAM
TM
YMCA of Greater Indianapolis 11/3/2010
615 N Alabama St Suite 200
L Indianapolis IN 46204 -1359 Invoice No. 14 11635
(317)2e6-9622 fax: (317) 266 -2845 I NV OI C E
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
November 2010
Name YMCA Employee Employer Type Date of Birth Remarks
Allen, Brad
Subtotals 0.00 220.60
20 employees Total Due $220.50
Please remit to: Q a
YMCA of Greater Indianapolis Terms: Net 30 days D
615 N. Alabama Street NOV 0 8 2010
Indianapolis, IN 46204
By
Page 1
j
YMCA membership fees for the month of
November 2010
Name YMCA Employee Employer Type Date of Birth Remarks
Additions this period:
None
Cancellations this period:
Holubik, Steve
Cancelled 10 -31 -10
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
$220.50
ON ACCOUNT OF APPROPRIATION FOR
Carmel HR Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
19344 I 1411635 1 43-419.801 $220.50 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, November 08, 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))
11/03/10 I 1411635 I I $220.50
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
2d
Clerk- Treasurer