HomeMy WebLinkAbout214865 11/20/2012 CITY OF CARMEL, INDIANA VENDOR: 366719 Page 1 of 1
ONE CIVIC SQUARE WELLNESS COUNCIL OF INDIANA
Ja CARMEL, INDIANA 46032 CHECK AMOUNT: $1,000.00
� 115 W WASHINGTON ST,STE 850 S
INDIANAPOLIS IN 46204 CHECK NUMBER: 214865
CHECK DATE: 11/20/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1201 R4341980 26421 11 . 02 . 12 1, 000 . 00 WELLNESS PROGRAM
Wellness Council of Indiana
I 15 W Washington St,Ste 850 S, Indianapolis, IN,46204,USA
Phone: (317)264-2168 Fax: (317)264-6855
www.wellnessindian.
CO
ELLN INVOICE
Date:02-Nov-2012 Order Number: 5000610386
Order Date, 02-Nov-2012
Bill-To:000000090785 Invoice Number:
City of Carmel
Ms.Sue Wolfgang
One Civic Sq
Carmel,IN 46032-2584
Product Fulfill Status Status Qty Unit Price Unit Adjustment Total
Discount
Wellness Council Member Dues A P 1 $1,000.00 $0.00 $0.00 $1,000.00
II/1/12 to 10/31/13
1100%of Wellness Council of Indiana membership dues are tax deductible. Shipping: $0.00
Sales Tax: $0.00
Total- $1,000.00
Paid To Date:
Current Amount Due. $1,00000
E/A—\ 0
D
NOV 19 2012
Y----------
Please detach the lower portion and return it with your payment.Thank you.
VOUCHER NO. WARRANT NO.
ALLOWED 20
Wellness Council of Indiana
IN SUM OF $
115 W Washington St, Ste 850 S
Indianapolis, IN 46204
$1,000.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel HR Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
26421 11.02.12 43-419.80 $1,000.00 I hereby certify that the attached invoice(s), or
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
Monday, November 19, 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))
11/02/12 11.02.12 $1,000.00
1 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