HomeMy WebLinkAbout224169 09/10/2013 CITY OF CARMEL, INDIANA VENDOR: 366719 Page 1 of 1
ONE CIVIC SQUARE WELLNESS COUNCIL OF INDIANA
CARMEL, INDIANA 46032 115 W WASHINGTON ST,STE 850 S CHECK AMOUNT: $1,000.00
INDIANAPOLIS IN 46204
CHECK NUMBER: 224169
CHECK DATE: 9/10/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1201 R4341980 26421 5000624524 1, 000 . 00 WELLNESS PROGRAM
-� Wellness Council of Indiana
115 W Washington St, Ste 850 S,Indianapolis,IN, 46204,USA
0
Phone: (317)264-2168 Fax: (317)264-6855
Gov� P P www.wellnessindiana.org
WELLNESS
IN COOPERfllxoN
Membership Renewal Statement
Date:3-Sep-13 Order Number: 5000624524
Order Date: 9/3/2013
Bill-To:000000090785 Invoice Number:
City of Carmel
One Civic Sq
Carmel,IN 46032-2584
Product Fulfill Status Status Qty Unit Price Unit Adjustment Total
Discount
Wellness Council Member Dues A P 1 $1,000.00 $0.00 $0.00 $1,000.00
11/1/2013 to 10/31/2014
Shipping: $o
Sales Tax: $0
Total: $1,000.00
Paid To Date:
Current Amount Due: $1,000.00
D
SEF 0 9 2013
By
-
Please detach the lower portion and return it with your payment.Thank you.
-----------.................................................................. - ------------- .......... ........-----------------...-.-------------------------------------------. -°---.............. -----------------------------------.................----------------
Call Laura at(317)2643793 to pay by credit card,or make checks payable to Wellness Council of Indiana
Customer:000000090785 City of Cannel Wellness Council Membership Dues(USD):$1,000.00
Order No:5000624524
Credit Card# Exp.Date: /
Amount:
Credit Cards Accepted-(AE,MS,VS)
Send payments to: Wellness Council of Indiana
115 W Washington St
Ste 850 S
Indianapolis, IN 46204
VOUCHER NO. WARRANT NO.
ALLOWED 20
Wellness Council of Indiana
IN SUM OF $
115 W Washington St, Ste 850 S
Indianapolis, IN 46204
$1,000.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel HR Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
ija ) I 5000624524 I 43-419.80 I $1,000.00 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
Monday, September 09, 2013
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))
09/03/13 5000624524 Dues $1,000.00
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