173098 05/27/2009 a CITY OF CARMEL, INDIANA VENDOR: 355549 Page 1 of 1
ONE CIVIC SQUARE Y M C A
CHECK AMOUNT: $233.70
CARMEL, INDIANA 46032 615 N ALABAMA ST SUITE 200
q, oN co INDIANAPOLIS IN 46204 -1359 CHECK NUMBER: 173098
CHECK DATE: 5/27/2009
DEP ARTMENT ACCO PO NUMBER IN NUMB AMOUNT DESCRIPTION
1201 4341980 1061240 233.70 WELLNESS PROGRAM
"1 YMCA of Greater Indianapolis
Indiana 5/7/2009
p
615 N Alabama St Suite 200
Indianapolis IN 46204 -1359 Invoice No. 1061240
(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
May 2009
Name YMCA Employee Employer Type Date of Birth Remarks
Allen, Brad 07- 167698 0.00 10.95 Adult HH 2
Subtotals 0.00 1 233.70
22 employees Total Due $233.70
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
May 2009
Name YMCA Employee Employer Type Date of Birth Remarks
Additions this period:
None
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
Y A,A Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
05107/09 1061240 Monthly me May 2009 S23370
$233.74
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 NQ5 /22/09 WARRANT NO.
po is
ALLOWED 20
Pluldn '815 N. Alabama ree to 200 IN SUM OF
Indianapolis, IN 46204 -1432
$233.70
r
ON ACCOUbT&g LQp UND N FOR
1201 Human Resources
Board Members
D INVOICE NO. ACCT #/TITLE AMOUNT I hereby certify that the attached invoice(s), or
1061240 419 -80 $233.70 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
a
I S,Wnatu
1 Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund