169216 02/17/2009 CITY OF CARMEL, INDIANA VENDOR: 355549 Page 1 of 1
ONE CIVIC SQUARE YMCA
�I' CHECK AMOUNT: $439.43
GARMEL, INDIANA 46032 615 N ALABAMA S7 SUITE 200
•w og INDIANAPOLIS IN 46204 -1359 CHECK NUMBER: 169216
CHECK DATE: 2/1712009
D EPAR T MENT AC PO NUM INVO NUMBE AMOUNT DESCRIPTION
1201 4341980 4 960159 439.43 WELLNESS PROGRAM—
is
YMCA of Greater Indianapolis 2/3/2009
615 N Alabama St Suite 200
Indianapolis IN 46204 -1359 Invoice No. 999907
(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
February 2009
Name YMCA Employee Employer Type Date of Birth Remarks
Allen, Brad 07- 167698 0.00 10.95 Adult HH 2
Subtotals 0.00 233.33
zj fi b <u
20 employees Total Due $233.33
Please remit to:
D
YMCA of Greater Indianapolis Terms: Net 30 days
615 N. Alabama Street
Indianapolis, IN 46204 .(33
Page 1
YMCA membership fees for the month of
February 2009
Name YMCA Employee Employer Type Date of Birth Remarks
Additions this period:
Condra, Kyle 15- 100158 0.00 10.95 1 Adult HH 2
lJoined 1 -2 -09
Cancellations this period:
None
Page 2
02/0612009 09:49 3176363237 YMCA PAGE 02103
YMCA of Greater Indianapolis GEE)
615 N Alabama St Suite 200
Indianapolis IN 46204-1359 Invoice No, 9601 693
(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
December 2008
Name YMCA Employee Employe Type Date of Birth Remarks
Allen, Brad 07-167698 0.00 10.65 Adult HH 2) 1111911976
Baskerville, Anthony 15 -312277 0,00 10.65 Adult HH (L 0713111971
Brisco, Michael 15-36029 0.00 10.65 Adult HH (2) 04116/1969
Cromlich, Mark 15-17337 0.00 10.65 Adult HH (2) 04/04/1069
Dorsch, Jim 15-35796 0.00 10.65 Adult HH (2) 08/0411969
Duncan. Gary Jr. 08-223938 0.00 10.65 Adult HH (2) 12/07/1970
Ellison, Chris 01-59211 0.00 10.65 Adult HH (2) 02/2511974
Giles, Greg 15-32620 0.00 10,65 Adult HH (2) 05/10/1973
Hoffman, Matthew 15-40575 0.00 7.20 Adult 11/28/1966
Holubik, Steve 12-215404 0.00 10.65 Adult HH (2) 07/2211960
Huffman, David 15-147939 0.00 21.30 Adult HH (2) 07/0911965
Liggett, Brent 15-333338 0.00 10.65 Adult HH (2) 09/0911974
McManama, Carol 12-119123 0,00 7.20 Adult 08109/1947
McNair, Harland 15-35476 0.00 10.65 Adult HH (2) 12/1611971
113ansford, Brett 16 -4888 0-00 10.65 Adult HH (2) 1011911963
ISchlaegel, Courtney 12-202628 0.00 10-65 Adult HH (2) 06/15/1980
Spearman, Ted 15-223945 0.00 10,65 Adult HH (2) 06/14/1961 1 i f
Stindle, Kevin 15-34987 0.00 10.65 Adult HH (2) 03/17/1978
Wynn, Barb 15-41643 0.00 10.65 Adult HH (2) 0412911967
Subtotals 0.00 206.10
19 employees Total Due
Please remit to.
YMCA of Greater Indianapolis Terms: Net 30 days
616 N. Alabama Street
Indianapolis, IN 46204
Additions this period:
Page 1
02106/2009 09:49 3176363237 YMCA PAGE 03/03
YMCA membership fees for the month of
December 2008
Name YMCA Employee Employe Type Date of Birth Remarks
]Huffman, David 15-147939 0.00
10.65 1 Adult HH (2)l
lJoined 12-1-08
Cancellations this Period:
None
Page 2
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Flev. 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 /16/O9 WARRANT NO.
napo Is ALLOWED 20
615 N. Alabama Street, Ste 200- IN SUM OF
Indianapolis, IN 46204 -143
$439.43
oN AccoUIbOeRFAL FUNDON FOR
1201 Human Resources
Board Members
PO# or
D PT. INVOICE NO. ACCT /TITLE AMOUNT I hereby certify that the attached invoice(s), or
1201 960159 419 -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
s
Si a re
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund