215327 12/11/2012 CITY OF CARMEL, INDIANA VENDOR: 366750 Page 1 of 1
ONE CIVIC SQUARE GYM41
CARMEL, INDIANA 46032 5315 W 86TH STREET CHECK AMOUNT: $1,260.00
INDIANAPOLIS IN 46268 CHECK NUMBER: 215327
CHECK DATE: 12/11/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4340800 11/27/2012 1, 260 . 00 ADULT CONTRACTORS
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EDate: November 27, 2012 11
Gym41 TO: Carmel Clay Parks&
Recreation
f 5315 W 86`h Street Monon Community Center i
Indianapolis, Indiana 46268 1235 Central Park Drive East
317-508-5625 Carmel, IN 46032
P 317.573.5247
Lindsay @gym4l.com F 317.573.5254 i
SALESPERSON JOB PAYMENT DUE DATE
TERMS
Tully Bevilaqua I Basketball Clinic Due on Receipt 11/5/2012
DATE DESCRIPTION UNIT PRICE i QUANTITY TOTAL
10/23/12- 11/15/12 I Youth Basketball Clinic $120.00 10 $1,200.00
11/06/12- 11/15/12 Youth Basketball Clinic $60.00 (prorated) 1 $60.00
$1260.00 ,
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Make all checks payable: Gym41
�armnam THANK YOU FOR YOUR BUSINESS!
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NOV 2 2012
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BY:__ 1
Purchase 1
Description .J11 voi,
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Line Descr DU
Purchase "
Approv Date
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ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of 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.
Gym 41 Terms
5315 W 86th Street
Indianapolis, IN 46268
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
11/27/12 10123-11/15/12 Youth basketball clinic 29212 $ 1,260.00
Total $ 1,260.00
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
Voucher No. Warrant No.
Gym 41 Allowed 20
5315 W 86th Street
Indianapolis, IN 46268
In Sum of$
$ 1,260.00
ON ACCOUNT OF APPROPRIATION FOR
109 - Monon Center
PO#or INVOICE NO. ACCT#TTITLE AMOUNT Board Members
Dept#
1096-42 10/23-11/15/12 4340800 $ 1,260.00 1 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
6-Dec 2012
Signature
$ 1,260.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund