171151 04/16/2009 F CITY OF CARMEL, INDIANA VENDOR: 355549 Page 1 of 1
0 ONE CIVIC SQUARE Y M C A CHECK AMOUNT: $244.32
CARMEL. INDIANA 46032 615 N ALABAMA ST SUITE 200
INDIANAPOLIS IN 46204 -1359 CHECK NUMBER: 171151
CHECK DATE: 4/16/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1201 4341980 1040868 244.32 WELLNESS PROGRAM
M1
f
YMCA of Greater Indianapolis 4/3/2009
615 N Alabama St Suite 200
Indianapolis IN 46204 -1359 Invoice No. 1040868
(317) 266 -9622 fax: (317) 266 -2845
't i INVOICE
Bill to: City of Carmel (317) 571 -5850
Attn: Michele Whittington
Human Resources
1 Civic Square
Carmel IN 46032
YMCA mem bership. fees for the month of
April 2009
Name YMCA Employee Employer Type Date of Birth Remarks
Allen, Brad 07- 167698 0.00 10.95 Adult HH 2
Subtotals 0.00 243.42
22 employees Total Due
Please remit to:
YMCA of Greater Indianapolis Terms: Net 30 days !n✓' r-
615 N. Alabama Street
Indianapolis, IN 46204
Page 1
YMCA membership fees for the month of
April 2009
Name YMCA Employee Employer Type Date of Birth Remarks
Additions this period:
Conn, Angie 1 12- 391480 0.00 20.67 1 Adult HH 2 lJoined 3 -4 -09
Cancellations this period:
None
r'
Page 2
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
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 NW /09 WARRANT NO.
Greatbi ianapo Is
ALLOWED 20
ama Street, Ste 200 IN SUM OF
Indianapolis IN 46204 -1432
$244.32
ON Accou8JNERAL ON F
FUND
1201 Human Resources
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT I hereby certify hat the attached invoice(s), or
DEPT. y y
1201 1040868 19 -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
ignatur
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund