223690 08/27/2013 CITY OF CARMEL, INDIANA VENDOR: 367502 Page 1 of 1
4 � ONE CIVIC SQUARE JOSEPH WILLIAMSON
CARMEL, INDIANA 46032 3637 BRUMLEY WAY CHECK AMOUNT: $700.00
CARMEL IN 46033 CHECK NUMBER: 223690
CHECK DATE: 8/27/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
101 5023990 700 . 00 REFUND-GOLF MEMBERSHI
American
Network
American Health Network
10995 Allisonville Rd Ste 100
Fishers IN 46038-2616
Phone: (317) 842-7928
08/19/2013
Joseph Williamson
3637 Brumley Way
Carmel, IN 46033
To Whom It May Concern:
Please consider this a letter of Medical Necessity for Joseph Williamson and my recommendation for him to avoid playing golf at this time/until further
notice due to health issues.
Thanks,
Joseph Williamson (:NOT FOUND}
772823
VOUCHER NO. WARRANT NO.
ALLOWED 20
Joseph Williamson
IN SUM OF$
3637 Brumley Way
Carmel, IN 46033
$700.00
ON ACCOUNT OF APPROPRIATION FOR
Brookshire Golf Club
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
—r
1207 I American Health I.3 �a/3 I $700.00 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
Thursday, August 22, 2013
Director, Brooks re Golf Club
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))
08/19/13 erican Health Net Membership Fee $700.00
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