168622 02/04/2009 CITY OF CARMEL, INDIANA VENDOR: 360927 Page 1 of 1
ONE CIVIC SQUARE NATL INDEPENDENT HEALTH CLUB AS
O 4 SpC
CARMEL, INDIANA 46032 4001OTH ST NW
CHECK AMOUNT: $99.00
NEW BRIGHTON MN 55112
CHECK NUMBER: 168622
CHECK DATE: 2/4/2009
DEPARTMENT ACCOUNT PO NUMBER IN NUMBE AMOUNT DESCRIPTION
1047 4355300 4543 99.00 ORGANIZATION MEMBER
�M
RFC ,"FT \7'PD Sent 1/27/2009
.JAN 2 7 2009
[BY:
NIHCA Membership
N
Renewal Invoice
n
Monon Center at Central Park, The #4543
Thank you for your participation and membership! This is to
inform you that your membership is due for renewal to
continue with the insurance reimbursement program(s).
Please pay by check or credit card upon receipt of this
notice. Please include your 4 digit club number when
sending a check.
Year Due Paid Balance
2009 $99 $0 $99
Total Amount Due $99
If you have questions, Please call us at 651.554.9416,
or 866.484.9173
If you are choosing to cancel instead of paying th' i voice, please
email us at infognihca.org
PA 9 por
O.L 2)
Thank you!
National Independent Health Club Association
400 10 St. NW, Suite 229, New Brighton, MN 55112
651 -554 -9416 Toll Free 866 484 -9173 Fax 651 -554 -9935
ACCOUNTS PAYABLE VOUCHER
T CITY OF CARMEL
An invoice of bill to be properly itemized must show; kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
National Independent Health Club Association Terms
400 10th Street NW, Suite 229
New Brighton, MN 55112
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
1/27/09 4543 Annual membership 99.00
Total 99.00
I hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and I have audited same in accordance
with IC 5- 11- 10 -1.6
,20_
Clerk- Treasurer
Voucher No. Warrant No.
National Independent Health Club Associatio Allowed 20
400 10th Street NW, Suite 229
New Brighton, MN 55112
In Sum of$
99.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 4543 4355300 99.00 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
2 -Feb 2009
Signature
99.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund