HomeMy WebLinkAbout205021 12/20/2011 CITY OF CARMEL, INDIANA VENDOR: 355549 Page 1 of 1
ONE CIVIC SQUARE YMCA
CARMEL, INDIANA 46032 615 N ALABAMA ST SUITE 200 CHECK AMOUNT: $256.02
INDIANAPOLIS IN 46204 -1359 CHECK NUMBER: 205021
CHECK DATE: 12/20/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1201 R4341980 21668 1703038 256.02 WELLNESS PROGRAM
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YMCA of Greater Indianapolis 12/6/2011
615 N Alabama St Suite 200
the Q Indianapolis IN 46204 -1359 Invoice No. 1703038
ma c. (317) 266 -9622 fax: (317) 266 -2845
INVOICE
Bill to: City of Carmel 317 571 -5850
Attn: Michele Whittington
Human Resources, 1 Civic Square
Carmel, IN 46032
YMCA meribership fees for the month of,
December 2011
Name YMCA Employee Employer Type Date of Birth Remarks
Brisco, Michael 15 -36029 0.00 11.85 Adult HH 2 04/16/1969
Conn, Angie 12- 391480 0.00 11.85 Adult HH 2 12/25/1979
Crawford, Elizabeth 20- 515280 0.00 14.97 Adult HH 2 12/11/1984
Cromlich, Mark 15 -17337 0.00 10.05 Adult HH 1 07/06/1955
Delon g, Mike 15- 485527 0.00 11.85 Adult HH 2 11/28/1975
Dorsch, Jim 15 -35796 0.00 11.85 Adult HH 2 08/04/1969
I Duncan, Gary Jr. 08- 223938 0.00 11.85 Adult HH 2 12/07/1970
Edwards, Steve 15- 162725 0.00 11.85 Adult HH 2 07/06/1955
Ellison, Chris 01 -59211 0.00 11.85 Adult HH 2 10/14/1974
Giles, Greg 15 -32620 0.00 11.85 Adult HH 2 04/13/1969
Gu el, Mark 15- 177563 0.00 11.85 Adult HH 2 09/26/1968
Hobbs, James 15 -7690 0.00 11.85 Adult HH 2 12/09/1963
Hoffman, Matthew 15 -40575 0.00 10.05 Adult HH 1 11/28/1966
Holubik, Steve 12- 215404 0.00 11.85 Adult HH 2 07/22/1960
Liggett, Brent 15- 333338 0.00 11.85 Adult HH 2 09/09/1974
Mast, Darren 15- 181913 0.00 11.85 Adult HH 2 03/23/1967
McManama, Carol 12- 119123 0.00 7.65 Adult 08/09/1947
McNair, Harland 15 -35476 0.00 11.85 Adult HH 2 12/16/1971
Ransford, Brett 15 -4888 0.00 11.85 Adult HH 2 10/19/1963
S earman, Ted 15- 223945 0.00 11.85 Adult HH 2 06/14/1961
Watts, Trent 15- 233187 0.00 11.85 Adult HH 2 09/06/1972
Woodburn, Scott 15- 527507 0.00 11.85 Adult HH 2 06/24/1981
Subtotals 0.00 256.02
22 employees Total Due
Please remit to:
D
YMCA of Greater Indianapolis Terms: Net 30 days ULL 19 2011
615 N. Alabama Street
Indianapolis, IN 46204
By
Page 1
YMCA membership fees for the month of
December 2011
s
Name YMCA Employee Employer Type Date of Birth Remarks
Additions this period:
Crawford, Elizabeth 1 20- 515280 1 0.00 1 14.97 1 Adult HH 2 12/11/1984 lJoined 11 -22 -11
Cancellations this period:
None
Page 2
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))
12/06/11 1703038 $256.02
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
YMCA of Greater Indianapolis
IN SUM OF
615 N. Alabama St., Suite 200
Indianapolis, IN 46204 -1359
$256.02
ON ACCOUNT OF APPROPRIATION FOR
Carmel HR Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
21668 1703038 43- 419.80 $256.02 I 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 19, 2011
Director, HR
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund