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HomeMy WebLinkAbout204377 12/06/2011 u�. CITY OF CARMEL, INDIANA VENDOR: 365861 Page 1 of 1 ONE CIVIC SQUARE RUNNERS FORUM OF CARMEL, INC CHECK AMOUNT: $7,100.00 CARMEL, INDIANA 46032 620 STATION DRIVE CARMEL IN 46032 CHECK NUMBER: 204377 CHECK DATE: 12/6/2011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1201 R4341980 21668 617 7,100.00 WELLNESS PROGRAM GIFT Runners Forum of Carmel, Inc. Invoice Station Drive Carmel, 1N 46032 RUNNERS ;DATE' (317)844 -1558 FORUM 12/01/2011 617 RunnersForum @RunnersForum.com „TERMS .`UE €DATEx f Net 15 12/16/2011 City of Carmel One Civic Square Carmel, IN 46032 e AMOUNT NCL®SE1] $7,100.00 PJczue detachi tup (.tt�3 ticm ��7c6 YEtuErt wit7� 1our �?rab'mtnt. ;.�r'$s ,.e_ D�tPJ �-F,.Acti��ty..., �Quant�ty Rate�� A�mounf 12/01/2011 4 Quarter Wellness Partiepant gift cards 71 100.00 7,100.00 D Gil; 5 2011 By The Runners Form appreciates your business! s` TOTAL�$7;100 #00 VOUCHER NO. WARRANT NO. ALLOWED 20 Runners Forum of Carmel, Inc IN SUM OF 620 Station Drive Carmel, IN 46032 $7,100.00 ON ACCOUNT OF APPROPRIATION FOR Carmel HR Department PO# 1 Dept. INVOICE NO. ACCT #iTITLE AMOUNT Board Members lb 617 43- 419.80 $7,100.00 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, December 05, 2011 t,_ 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)) 12/01/11 617 $7,100.00 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