175235 07/22/2009 ..a CITY OF CARMEL, INDIANA VENDOR: 355549 Page 1 of 1
0 ONE CIVIC SQUARE YMCA CHECK AMOUNT: $211.80
CARMEL, INDIANA 46032 615 N ALABAMA S7 SUITE 200
INDIANAPOLIS IN 46204 -1359 CHECK NUMBER: 175235
CHECK DATE: 7/22/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1201 4341980 1102124 211.80 WELLNESS PROGRAM
YMCA of Greater Indianapolis
615 N Alabama St Suite 200 G/8/2009
Indianapolis IN 46204 -1359 Invoice No. 1102124
(317) 266 -9622 fax: (317) 266 -2845
�t 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
July 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
July 2009
Name YMCA Employee Employer Type Date of Birth Remarks
Additions this period:
None
Cancellations this period:
Condra, Kyle 15- 100158 1 0.00 1 10.95 1 Adult HH 2 ICancelled 6 -30 -09
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
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
VOUCHE WARRANT NO.
20 09�'
ALLOWED 20
YMCA of Greater Indianapolis
IN SUM OF
615 N. Alabama Street, Ste 200
Indianapolis, IN 46204-1432
$211.80
ON ACCOUNT OF APPROPRIATION FOR
GENERALFUND
1201 Human Resources
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
1201 -J-10:21:24 419 RQ TOAA-gn 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
b Sig at r yl Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund