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
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City of Carmel
One Civic Square
Carmel, IN 46032
e AMOUNT NCL®SE1]
$7,100.00
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12/01/2011 4 Quarter Wellness Partiepant gift cards 71 100.00 7,100.00
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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