HomeMy WebLinkAbout202686 10/11/2011 CITY OF CARMEL, INDIANA VENDOR: 365238 Page 1 of 1
~f ONE CIVIC SQUARE NATHAN STAPLETON
CHECK AMOUNT: $250.00
CARMEL, INDIANA 46032 PO BOX 701
ARCADIA IN 46030 CHECK NUMBER: 202686
CHECK DATE: 10/11/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1201 R4341980 21668 419 -80 250.00 WELLNESS PROGRAM
CITY OF CARMEL WELLNESS PROGRAM
PRIZE /REWARD STATEMENT
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Date: October 7, 2011
Name of Prize /Reward: Q3 Aerobic Minutes Advanced Level
Amount: 50.00
Line Item: 419 -80
Check Made Out To: NATHAN STAPLETON (Street)
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CITY OF CARMEL WELLNESS PROGRAM
PRIZE /REWARD STATEMENT
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Date: October 4, 2011
Name of Prize /Reward: 3rd Quarter Weight Loss Challenge Top Male
Amount: 200.00
Line Item: 419 80
Check Made Out To: Nathan Stapleton
(Street Department)
Please Return Check to Sue Coy in Human Resources
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VOUCHER NO. WARRANT NO.
ALLOWED 20
Stapleton, Nathan
IN SUM OF
Employee
$250.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel HR Department
PO# I Dept. INVOICE NO. ACCT #(TITLE AMOUNT Board Members
21668 419 -80 43- 419.80 $200.00 1 hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
21668 1 419 -80 1 43- 419.80 $50.00
materials or services itemized thereon for
which charge is made were ordered and
received except
Monday, October 10, 2011
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))
10/04/11 419 -80 3rd Qtr Wght Loss Challenge $200.00
10/07/11 419 -80 Q3 Aerobic Minutes $50.00
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
1 20
Clerk- Treasurer