HomeMy WebLinkAbout166029 11/12/2008 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: $174.15
INDIANAPOLIS IN 46204 -1359 CHECK NUMBER: 166029
CHECK DATE: 11/12/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DES
1201 4341980 174.15 WELLNESS PROGRAM
i
3+
t
f
YMCA of Greater Indianapolis 11/4/2008
615 N Alabama St Suite 200
Indianapolis IN 46204 -1359 Invoice No. 940269]
(317) 266 -9622 fax: (317) 266 -2845
®R INVOICE
R
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
i November 2008
r
Name YMCA Employee Employer Type Date of Birth Remarks
Allen, Brad 07- 167698 0.00 10.65 Adult HH 2 11/19/1976
Baskerville, Anthony 15- 312277 0.00 10.65 Adult HH 2 07/31/1971
Brisco, Michael 15 -36029 0.00 10.65 Adult HH 2 04/16/1969
Cromlich, Mark 15 -17337 0.00 10.65 Adult HH 2 04/04/1969
Dorsch, Jim 15 -35796 0.00 10.65 Adult HH 2 08/04/1969
Duncan. Gary Jr. 08- 223938 0.00 10.65 Adult HH 2 12/07/1970 i
Ellison, Chris 01 -59211 0.00 10.65 Adult HH 2 02/25/1974
Giles, Greg 15 -32620 0.00 10.65 Adult HH 2 05/10/1973
Hoffman, Matthew 15 -40575 0.00 7.20 Adult 11/28/1966
Holubik, Steve 12- 215404 0.00 10.65 Adult HH 2 07/22/1960
McManama, Carol 12- 119123 0.00 7.20 Adult 08/09/1947
McNair, Harland 15 -35476 0.00 10.65 Adult HH 2 12/16/1971
Ransford, Brett 15 -4888 0.00 10.65 Adult HH 2 10/19/1963
Schlae el, Courtney 12- 202628 0.00 10.65 Adult HH 2 06/15/1980
Spearman, Ted 15- 223945 0.00 10.65 Adult HH 2 06/14/1961
Stindle, Kevin 15 -34987 0.00 10.65 Adult HH 2 03/17/1978
Wy nn, Barb 15-41643 0.00 10.65 Adult HH 2 04/29/1967
a
Subtotals 0.00 174.15
17 employees Total Due $174.15
Please remit to:
YMCA of Greater Indianapolis Terms: Net 30 days
615 N. Alabama Street
Indianapolis, IN 46204
Additions this period:
None
Page 1
d
YMCA membership fees for the month of
November 2008
Name YMCA Employee Employer Type Date of Birth Remarks
4
Cancellations this period:
Edwards, Steven 15- 162725 0.00 10.65 1 Adult HH 2 01/10/1970 lCancelled 10 -31 -08
Page 2
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
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
YMCA Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
November 2un $174.15
Total
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
VOUCF jFjq WARRANT NO.
Y o rea ern la napolis ALLOWED 20
615 N. Alabama Street, Ste 200 IN SUM OF
In d w anap olis,- IN110204 143
$174.15
ON ACCOUNT OF APPROPRIATION FOR
GENERALFUND
1201 Human Resources
Board Members
PO# or D PT. INVOICE NO. ACCT #/TITLE AMOUNT I hereby certify that the attached invoice(s), or
1201 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
20
Sigrya�ur
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund