215989 01/09/2013 CITY OF CARMEL, INDIANA VENDOR: L2367 Page 1 of 1
` ONE CIVIC SQUARE CARMEL CLAY PARKS-MONON CENTER
CARMEL, INDIANA 46032 C/O AUDREY KOSTRZEWA CHECK AMOUNT: $347.78
'* CHECK NUMBER: 215989
CHECK DATE: 1/912013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1201 R4341980 26421 2012-228 347 . 78 WELLNESS PROGRAM
Carmel ® Clay Invoice
Parks&Recreation Date Invoice#
1411 E 116th Street
Carmel, IN 46032 12/28/2012 2012-228
Bill To
City of Carmel
One Civic Square
Carmel, IN 46032
Due Date
1/28/2013
Quantity Description Rate Amount
Monon Community Center Corporate Passes
December 28, 2012
47 Adult Pass (City of Carmel) 12.93 607.71
5 Youth or Senior Pass (City of Carmel) 8.50 42.50
31 Household Pass (City of Carmel) 35.08 1,087.48
D
JAN q 7 2013
By
Remit to:
Carmel Clay Parks& Recreation
1411 E. 116th St. Total Due $1,737.69
Carmel, IN 46032
Questions?317-573-4025
r. mm
o ° oo ° oo ° ° 000 ooaoo m ° ° ° mmm ° m ° ° ° ° m ° oo ° o ° oemmmm ° m ° o ° °
o a ° om ° ° ° ° ° ° ° ° ° ° ° ° mmm ° maa omo ° aa oo oo 0000m ° ° ° mmm ° mm ° ° ° ° om ° 000meomm ° m ° ° ° mm °°
888888888888888°88 48888888888888888888888888888888888888888888888888888888
4° ° ° °°°° °8351w°2 w 4o 41
E
m P>
8 -
w
m
a= >9 a > > > > >J 0 a a a a 5 a a 0 0 0 Q Q m a >> > 10 0 a $5 $ o
y N 2 S S S a S S a a 2 a 2 S a S S S S S S a 2 2 S a N 2 S a t Q a 2 S S S S S A S S 2
F
Y�� m m
f7¢U
E
o c n w m m o
J Q m m m m R U U U U U U S
K
O
o h
U
° ry n ry n n n e e ry n n�n n in n e n ry n ry ry n n n ry n n n ry n r n�m n ry ry n ry N n�m ry ry ry ry ry ry e ry n n n n n ry n n n n n n n ry n�n n n ry n t°
E $$ o$$ r $
a o -z%%o a a t- -
°a°a °a°a h°a x°°a x°°a x°°a°¢<x x x 2°a i°a i ° -
0
ry C C C
o C o$ Sry$$n C N
w am;,,aaa,o �a mac"a° ; ems mm a ;e° emae, m2;meaCeaa
r�c� ofsoa�
o E "s G 4 @ 0 z s E
E? _= R�Ia m e g C x z v z 8 a o E
z ¢ =° m sm`uciuvv �uu o`o°w°6�-LLu uo uuuii ° xYl ��x 3m E EE S��z°a00aas - `N N ���1��3�i
SUNGARD PENTAMATION, INC. PAGE NUMBER: 172
DATE: 12/25/2012 CITY OF CARMEL MODULE NUM: PAYCHK43
TIME: 21:06:21 DEDUCTION REGISTER CHECK DATE 12/28/2012
PAY RUN 226 PR 1226 2012
361 - MONON CENTER PAYROLL DED
EMPLOYEE EMPLOYER
EMPLOYEE ----------EMPLOYEE NAME---------- SUBJECT WAGES ACCOUNT DEPARTMENT DEDUCTION CONTRIBUTION ARREARS
250 ARNONE JANET
2200 20.69 .00 .00
SUNGARD PENTAMATION, INC. PAGE NUMBER: 173
DATE: 12/25/2012 CITY OF CARMEL MODULE NUM: PAYCHK43
TIME: 21:06:21 DEDUCTION REGISTER CHECK DATE 12/28/2012
PAY RUN 226 PR 1226 2012
361 - MONON CENTER PAYROLL DED
EMPLOYEE EMPLOYER
EMPLOYEE ----------EMPLOYEE NAME---------- SUBJECT WAGES ACCOUNT DEPARTMENT DEDUCTION CONTRIBUTION ARREARS
962 PITMAN MICHAEL
1,389.91 .00 .00
VOUCHER NO. WARRANT NO.
ALLOWED 20
Carmel Clay Parks and Recreation - Monon Ce
c/o Audrey Kostrzewa IN SUM OF $
1411 E. 116th St.
Carmel, IN 46032
$347.78
ON ACCOUNT OF APPROPRIATION FOR
Carmel HR Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Prior Year I hereby certify that the attached invoice(s), or
26421 2012-228 43-419.80 $347.78
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
n Monday, January 07, 2-013
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))
12/28/12 2012-228 $347.78
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