176514 08/19/2009 CITY OF CARMEL, INDIANA VENDOR: 355549 Page 1 of 1
ONE CIVIC SQUARE Y M C A
CARMEL, INDIANA 46032 615 N ALABAMA ST SUITE 200 CHECK AMOUNT: $211.80
INDIANAPOLIS IN 46204 -1359
CHECK NUMBER: 176514
CHECK DATE: 8/19/2009
DEPA RTME N T ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1201 4341980 1122355 211.80 WELLNESS PROGRAM
s.
r
N; YMCA of Greater Indianapolis 8/4/2009
615 N Alabama St Suite 200
Indianapolis IN 46204 -1359 Invoice No. 1122355
(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 membership fees for the month of
August 2009
Name YMCA Employee Employer Type Date of Birth Remarks
Allen, Brad 07- 167698 0.00 10.95 Adult HH 2
Subtotals 0.00 211.80
20 employees Total Due $211.80
Please remit to:
YMCA of Greater Indianapolis Terms: Net 30 days
615 N. Alabama Street
Indianapolis,,-IN- 46204
Page 1
YMCA membership fees for the month of
August 2009
Name YMCA Employee Employer Type Date of Birth Remarks
Additions this period:
None
Cancellations this period:
None
Page 2
Prescribed by Slate Board olAccounts 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
YMCA Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
Total
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 f 4� 17/09 WARRANT NO.
F !VP
apo is ALLOWED 20
ama St reet, Ste 200 IN SUM OF
Indianapolis, IN 46204 143?
$211.80
ON ACCOI IN J gXL FUND ON FOR
1201 Human Resources
Board Members
PO# INVOICE NO. ACCT #/TITLE AMOUNT I hereby certify hat the attached invoice(s), or
DEPT. y y
1201 112235 19 -80 $211.80 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
20
Jy,
Si tre
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund