215452 12/11/2012 �., CITY OF CARMEL, INDIANA VENDOR: 355549 Page 1 of 1
0 ONE CIVIC SQUARE YMCA CHECK AMOUNT: $240.75
.CARMEL, INDIANA 46032 615 N ALABAMA ST SUITE 200
INDIANAPOLIS IN 46204-1359 CHECK NUMBER: 215452
CHECK DATE: 12/1112012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1201 R4341980 26421 2020032 240 . 75 WELLNESS PROGRAM
-.s 12/6/2012
YMCA of Greater Indianapolis
the 615 N Alabama St Suite 200
Indianapolis IN 46204-1359 Invoice No.
(317) 266-9622 fax: (317) 266-2845 2020032
INVOICE
Bill to: City of Carmel �(��1�` I 317-571-5850
Attn: J. Spelbring
Human Resources, 1 Civic Square D A
Carmel, IN 46032
DEC 10 2012
YMCA membership fees for the month of
December 2012 By
t
Name YMCA# Employee Employer Type Date of Birth Remarks
n
Akers, Bill 15-23800 0.00 12.30 Adult HH (2)
Subtotals 0.00 240.75
Pagel
YMCA membership fees for the month of
• December 2012
Name YMCA# Employee Employer Type Date of Birth Remarks
21 employees Total Due $240.75
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:
None
I Cancellations this period:
Duncan, Gary Jr. 08-223938 0.00 12.30 Adult HH (2) 1
ICancelled 11-30-12
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
$240.75
ON ACCOUNT OF APPROPRIATION FOR
Carmel HR Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
26421 2020032 43-419.80 $240.75
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, December 10, 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))
12/06/12 2020032 $240.75
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