194983 03/02/2011 CITY OF CARMEL, INDIANA VENDOR: L2367 Page 1 of 1
R 0 ONE CIVIC SQUARE CARMEL CLAY PARKS -MONON CENTER
CARMEL, INDIANA 46032 C/O AUDREY KOSTRZEWA CHECK AMOUNT: $328.47
CHECK NUMBER: 194983
CHECK DATE: 3/2/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1201 4341980 2010 -269 328.47 WELLNESS PROGRAM
Carmel Clay lnvoo ce
Parlks Recre ation Date invoice
141 E 116th Street 2/24/2011 2010 -269
Carmel, IN 46032
Bill To
City of Carmel
One Civic Square
Carmel, IN 46032
Due Date
3/24/2011
Quantity Description Rate Amount
For Payroll 2.25.2011
49 Adult Pass (City of Carmel) 12.93 633.57
3 Youth or Senior Pass (City of Carmel) 8.50 25.50
28 Household Pass (City of Carmel) 35.08 982.24
D Q
FEB 2 8 2011
By
Remit to
Carmel Clay Parks Recreation �o$�I �U
1411 E. 116th St. $1 ,641.31
Carmel, IN 46032
Questions? 317- 573 -4025 Payment due 30 days from invoice date.
corppass @carmelclayparks -.com Please return one copy with payment.
Name Payroll Membership Emplo City Total Due
tttectrve Uate Type 1 Last Flame First Pass Type BI-Weekly
Alvey, Rick 7/2/2010 Household 128.06 7.02 1 35.08 1 Alvey IRirk I Household $35.08
Arnone, Janet 1112912010 Adult 10.34 2.59 12.93 lArnone Janet I Adult $12.93
Beck, Micah 1211412011 Adult 10.34 2.59 12.93 lBeck IMicah I Adult $12.93
Blanchard, Jim 161812007 Household 28.06 7.02 35.08 Blanchard (James I Household $35.08
Brant, Kenneth 2/12/20110 Household 28.06 7.02 35.08 Brant lKenneth I Household I $35.08
Buhmann, Kevin 171612007 Household 28.06 7.02 35.081 Buhmann IKe vin I Household $35.08
Burke, Raphael 5126/2010 Household 28.06 7.02 35.081 Burke Raphael I Household $35.08
Callahan, Mark 11121/2011 Household 28.06 7.02 35.081 Callahan Mark I Household $35.08
Campbell, R. Scott 161812007 Household 28.06 7.02 35.081 Campbell R. Scott Household $35.08
Carter, Ron 41l 112008 Senior /Adult 17.14 4.29 21.43 Carter Ron I SeniorlAdult $21.43
Cooper, Jeffery 674/2010 Household 128.06 7.02 35.08 Cooper Jeffrey I Household $35.08
Cox, Justin 1019 2009 Adult 10.34 2.59 12.931 Cox Justin Adult $12.93
Coy, Sue 6/8/2007 Household 128.06 7.02 35.08 Coy Susan Household 1 1
Dailey, Penny 1211712010 Adult 10.34 2.59 12.93 Daley Penny Adult $12.93
Dawson, Gregory 1/6/2011 Adult 1 Youth 20.69 5.17 25.86 Dawson Greg Adult, Adult $25.86
Deitsch, Marc 2/12/2010 Household 28.06 7.02 35.08 Deitsch Marc Household $35.08 1
Dietz, Aaron 6/6/2008 Household 10.34 2.59 12.931 Dietz Aaron Adult $12.93
Drake, Carl 5/9/2008 Adult 10.34 2.59 12.93 Drake Cad Adult $12.93
Duffy, John 12/12/2010 Household 28.06 7.02 35.08 Duffy John Household $35.08 I
Edwards, Steve 2/1212010 Adult 28.06 17.02 35.08 Edwards Steven Household $35.08 I
Essex, Cory 2/26/2010 Adult/Adult 20.69 15.17 25.86 Essex Cory Adult, Ault $25.86 I
Fa gin, Timothy 1/28/2011 Adult 10.34 12.59 12.93 Fagin Timothy Adult $12.93
Faucett, Joseph 8/2V2010 Household 28.06 17.02 35.08 Faucett Joseph Household $35.08 I
Gilbert, William 3/14/2008 Adult 1 Adult 20.69 5.17 25.86 Gilbert William Adult $25.86 1
Griffin, Tim 9/14/2007 Household 28.06 17.02 35.08 Griffin Tim Household 1 $35.08 1
Griffiths, Pam 618/2007 Household 28.06 7.02 35.08 Griffiths Pamela Household 1 $35.08 1
Grimes, Jeff 8/9/2010 Adult 10.34 12.59 1 12.93 Grimes Jeff Adult 1 $12.93 1
Hicks, Jeffrey 1/2/2009 Adult/Adult 20.69 1517 1 25.86 Hicks Jeff Adult, Adult 1 $25.86
Hollander, Greg 2/12/2010 Household 20.69 1517 1 25.86 Hollander Greg Adult, Adult 1 $25.86 1
Hollibaugh, Michael 7/6/2007 Household 28.06 17.02 1 35.08 Hollibaugh Michael Household 1 $35.08 1
Lafollette, Gary 6/8/2007 Adult 1 Adult 20.69 15,17 1 25.86 LaFollette Gary Adult, Adult $25.86
Locke, Robert 6/8/2007 Household 28.06 17.02 1 35.08 Locke Robert Household 1 $35.08
Luper, Michael 1311412008 Adult 10.34 12.59 12.93 Luper 11 Michael Adult 1 $12.93
Martin, Candy 3/172009 Adult 10.34 12.59 1 12.93 Martin Candy Aduit $12.93
Martin, Richard 672112010 Household 28.06 17.02 35.08 Martin Richard Household $35.08
Mascan, John 11011212007 Adult 10.34 2.59 12.93 Mascari John Adult $12.93
Massingill, Rand 19/12/2008 Adult 10.34 2.59 12.93 Massingill Randy Adult $12.93
Mast, Darren 17/612007 Adult 10.34 2.59 1 12.93 Mast Darren Adult I $12.93 I
McNab, John 1112/2009 Adult 10.34 2.59 1 12.93 McNab John Adult I $12.93
Meyer, Amanda 6/8/2007 Adult/Adult 20.69 5.17 25.86 Meyer Amanda Adult, Adult I $25.86
Miller, Adam 7/612007 Adult 10.34 2.59 12.93 Miller Adam Adult $12.93
Miller, Ken 1412312010 SeniorlAdult 34.29 8.57 42.86 _Miller Ken SeniorlAdult $42.86
1 Ken Miller Double Count and Deductions for pyrl 2.25.11 only month
Mishler, Nick 191312010 Household 28.06 7.02 35.08 Mishler Nick Household $35.08
Morgan, Trent 111512010 Adult 10.34 2.59 12.93 Morgan Trent Adult $12.93
Myers, Brady 121112008 Household 28.06 7.02 35.08 M yers Brady Household $35.08
Neville, Katie 1/15/2010 Adult 10.34 2.59 12.93 Neville Katie Adult $12.93
Orange, Doug 10/10/2008 Adult 10.34 2.59 12.93 Orange Doug Adult $12.93
Pattyn, Dawn 6/8/2007 Household 28.06 7.02 35.08 Pattyn Dawn Household $35.08
Pitman, Michael 2/1212010 Household 28.06 IT02 35.08 Pitman Michael Household $35.08
Platt, Jace 6/8/2007 Adult 10.34 12.59 12.93 Platt Jace Adult $12.93
Price, Joe 11211 8/2009 Household 28.06 17.02 35.08 Price Joseph Household $35.08
Rhodes, Kenneth 6/8/2007 Adult/Adult 20.69 5.17 25.86 Rhodes Kenneth Adult, Adult $25.86
Rider, Kevin 2/1/2008 AdulUAdult 20.69 5.17 25.86 Rider Kevin Adult, Adult $25.86
Schriner, Adam 1/2/2009 Adult/Adult 20.69 5.17 25.861 Schriner Adam Adult, Adult $25.86
Shar Rick 1011012008 Household 28.06 7.02 35.08 Sharp Rick Household $35.08
Smith, Jer ry 2/112008 Household 28.06 7.02 35.08 Smiley Landry Household $35.08
Smile Landry 111512010 Household 28.06 7.02 35.081 Smith Jerry Household $35.08
Steu ry, Kent 3/1/2009 Adult 10.34 2.59 12.931 Steury Kent Adult $12.93
Thomas, John 7/3/2008 Adult/Adult 20.69 5.17 25.861 Thomas John Adult, Adult $25.86
Tierne Scott 6/8/2007 Household 28.06 7.02 35.081 ITierney Scott Household $35.08
Tolan, Brian 1912912010 Adult 10.34 2.59 12.931 Tolan Brian Adult $12.93
Utzi Chad 6/8/2007 Household 28.06 7.02 35.08 U ig Chad Household $35.08
Whitlow, Sean 15/22/2009 Adult 10.34 2.59 I 12.93 Whitlow Sean Adult $12.93
Williams, Paula 11118/2010 Adult/Adult 20.69 5.17 25.86 Williams Paula Adult, Adult $25.86
Total Monthly Bill $1, fi41.31 i
I 1313.04 1328.27 11641.31 1
I I I I �I I I
SUNGARD PENTAMATION, INC. PAGE NUMBER: 174
DATE: 02/22/2011 CITY OF CARMEL MODULE NUM: PAYCHK43
TIME: 14:28:31 DEDUCTION REGISTER CHECK DATE 02/25/2011
PAY RUN 104 PR 1104
361 MONON CENTER PAYROLL DED
EMPLOYEE EMPLOYER
EMPLOYEE EMPLOYEE NAME---- SUBJECT WAGES ACCOUNT DEPARTMENT DEDUCTION CONTRIBUTION ARREARS
765 ALVEY RICHARD
1401 20.69 .00 .0 0
SUNGARD PENTAMATION, INC. PAGE NUMBER: 175
DATE: 02/22/2011 CITY OF CARMEL MODULE NOM: PAYCHK43
TIME: 14:28:31 DEDUCTION REGISTER CHECK DATE 02/25/2011
PAY RUN 104 PR 1104
361 MONON CENTER PAYROLL DED
EMPLOYEE EMPLOYER
EMPLOYEE EMPLOYEE NAME---- SUBJECT WAGES ACCOUNT DEPARTMENT DEDUCTION CONTRIBUTION ARREARS
1005 SCHRINER ADAM
1,312.84 00 .00
VOUCHER NO. WARRANT NO.
ALLOWED 20
Carmel Clay Parks and Recreation Monon Ce
IN SUM OF
c/o Audrey Kostrzewa
1411 E. 116th St.
Carmel, IN 46032
$328.47
ON ACCOUNT OF APPROPRIATION FOR
Carmel HR Department
PO# Dept. INVOICE NO. ACCT41TITLE AMOUNT Board Members
19375 I 2010 -269 I 43- 419.80 $328.47 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 28, 2011
Director, HR
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed by State Board ofACCOunts 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))
02/24/11 2010 -269 $328.47
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