HomeMy WebLinkAbout199677 07/20/2011 a CITY OF CARMEL, INDIANA VENDOR: 00352672 Page 1 of 1
ONE CIVIC SQUARE ADAM SCHRINER
CARMEL, INDIANA 46032 C/O DOCS CHECK AMOUNT: $25.00
CEO DOCS CHECK NUMBER: 199677
CHECK DATE: 7/20/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER A MOUNT DESCRIPTION
1201 R4341980 21668 25.00 WELLNESS PROGRAM
CITY OF CARMEL WELLNESS PROGRAM
PRIZE /REWARD STATEMENT
Date: 7/11/2011
Name of Prize /Reward: Q2 Team Weight Loss Challenge -Third Place
Amount: $25.00
Line Item: 419 -80
Check Made Out To: Adam Schriner DOCS
Please Return Check t® Sue C®y in Human Resources
D
/Q U
Jul.. 1$ 2011
By
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
whore, 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))
07/11/11 11 weight loss ch $25.00
I 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
VOUCHER NO. WARRANT NO.
ALLOWED 20
Schriner, Adam
IN SUM OF
Employee
$25.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel HR Department
PO# Dept. INVOICE NO, ACCT #!TITLE AMOUNT Board Members
21668 1 07.11.11 weight 43-419.801 $25.00 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, July 18, 2011
Director, HR
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund