209403 05/22/2012 CITY OF CARMEL, INDIANA VENDOR: 355549 Page 1 of 1
ONE CIVIC SQUARE Y M C A CHECK AMOUNT: $252.90
CARMEL, INDIANA 46032 615 N ALABAMA ST SUITE 200
INDIANAPOLIS IN 46204 -1359 CHECK NUMBER: 209403
CHECK DATE: 5122/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1201 R4341980 26421 1832326 252.90 WELLNESS PROGRAM
5/7/2012 llllll
YMCA of Greater Indianapolis
the 615 N Alabama St Suite 200 In voice No.
`Q Indianapolis IN 46204 -1359
(317) 266 -9622 fax: (317) 266 -2845 �b�z� 1832326
i
INVOICE
Bill to: City of Carmel 317 571 -5850
Attn: Michele Whittington D Q f
Human Resources, 1 Civic Square
Carmel, IN 46032 MAY 2 12012
YMCA membership fees for the month of B
May 2012 Y
i
Name YMCA Employee Employer Tvpe Date of Birth Remarks
Akers, Bill 15 -23800 0.00 11.85 Adult HH (2)
Page 1
I
YMCA membership fees for the month of
May 2012
Name YMCA Employee Employer Type Date of Birth Remarks
Subtotals 0.00 252.90
a
22 employees Total Due $252.90
Please remit to: q
YMCA of Greater Indianapolis Terms: Net 30 days
615 N. Alabama Street
Indianapolis, IN 46204 Please note: Accounts more than 90 days in arrears will be
assessed a 10% late fee of the total amount due
i Additions this period:
None
Cancellations this period:
Liggett, Brent 15- 333338 0.00 11.85 Adult HH (2) Cancelled 4 -30 -12
Page 2
VOUCHER NO. WARRANT NO.
ALLOWED 20
YMCA of Greater Indianapolis
IN SUM OF
615 N. Alabama St., Suite 200
Indianapolis, IN 46204 -1359
$252.90
ON ACCOUNT OF APPROPRIATION FOR
Carmel HR Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
26421 1832326 43 419.80 $252.90 I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
J
materials or services itemized thereon for
l which charge is made were ordered and
received except
Monday, May 21, 2012
Director, HR
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
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
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
05/07/12 1832326 $252.90
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