214881 11/20/2012 CITY OF CARMEL, INDIANA VENDOR: 355549 Page 1 of 1
ONE CIVIC SQUARE YMCA
CARMEL INDIANA 46032 615 N ALABAMA ST SUITE 200 CHECK AMOUNT: $279.05
,
INDIANAPOLIS IN 46204-1359
CHECK NUMBER: 214881
CHECK DATE: 11/20/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1201 R4341980 26421 1994118 279. 05 WELLNESS PROGRAM
kv
YMCA of Greater Indianapolis
"the 615 N Alabama St Suite 200
T Indianapolis IN 46204-1359 Invoice No.
(317) 266-9622 fax: (317) 266-2845 1994118
INVOICE
"Bill to: City of Carmel 317-571-5850
Attn: J. Spelbring
Human Resources, 1 Civic Square
Carmel, IN 46032
NOV 1 9 2012
YMCA membership fees for the month of
November 2012
By
Name YMCA# Employee Employer Type Date of Birth Remarks
Akers, Bill 15-23800 0.00 12.30 Adult HH (2)
Page 1
YMCA membership fees for the month of
November 2012
Name YMCA# Employee Employer Type Date of Birth Remarks
Subtotals 0.00 279.05
23 employees Total Due $279.05
Please remit to:
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
Additions this period:
�Manr rti Brian Jr. 15-501976 0.00 12.30 Adult HH (2)
lJoined 10-16-12
Cancellations this period:
t
None
i
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
$279.05
ON ACCOUNT OF APPROPRIATION FOR
Carmel HR Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
26421 1994118 43-419.80 $279.05 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))
11/06/12 1994118 $279.05
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