HomeMy WebLinkAbout239294 11/19/14 �,R ( CITY OF CARMEL, INDIANA VENDOR: 367222
ONE CIVIC SQUARE IU HEALTH WORKPLACE SERVICES LLCCHECK AMOUNT: $.....**772.00*
�9, /ra CARMEL, INDIANA 46032 2046 RELIABLE PKWY CHECK NUMBER: 239294
MiroN CHICAGO IL 60686-0020 CHECK DATE: 11119/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1201 4358800 736754 52.00 TESTING FEES
1205 4347500 736946 720.00 GENERAL INSURANCE
Indiana University Health Workplace Services,LLC
950 North Meridian Street
Suite 950 (City of Carmel)
Indianapolis, IN 46204
Phone: 317-963-1535
FEIN: 20-0994452
Invoice
November 03, 2014
Bill to: Barbara Lamb For: City of Carmel-Onsite
City of Carmel-Onsite EAP Services/Oct.2014
1 Civic Square
Carmel,IN 46032-
Invoice# 736946
Proc Code pate Description C� Charge Receipt Adiust Balance
EAPSERV 10/01/2014 EAP Services 600.00 720.00 720.00
Balance Due: 720.00
Invoice# 736946 Balance Due: 720.00
MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE
DATE-PLEASE INCLUDE INVOICE#ON CHECK
Cut and return with payment
VOUCHER`NO':' WARRANT NO.
ALLOWED - 20
IU Health Workplace Services, LLC
IN SUM OF$
.,.2046.Reliable:Pkwy
Chicago; IL 60686=0020`'
$720.00
ON ACCOUNT OF APPROPRIATION FOR
Administration Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT
Board Members
1205 I --736946 I 43-475.00 I $720.00 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
iwhich charge is made were ordered and
received except
1 li
Monday, No)�pmber 17, 2014
i
Director, Administration
Title
I
Cost distribution ledger classification if',. l
,claim paid motor vehicle highway fund l
I -
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. -.
f Invoice Invoice Description Amount.
Date Number (or note attached invoice(s)or bill(s))
11/03/14 736946 EAP Services $720.00
I hereby certify that the attached invoice(s), or bill(s), is(are)true and correct and I have audited same in accordarice
with IC 5-11-10-1.6 «
20
Clerk-Treasurer
India University Health Workplace Services,LLC
950 North Meridian Street
Suite 950 (City of Carmel)
�Zv Indianapolis, IN 46204
Phone: 317-963-1535
FEIN: 20-0994452
Invoice
November 03, 2014
Bill to: Barbara Lamb For: City of Carmel-Onsite
City of Carmel-Onsite Onsite/Oct.2014
1 Civic Square
Carmel,IN 46032-
Invoice# 736754
Proc Code Date Description -(aw Charge Receipt Adiust Balance
10/14/2014 Quick Read UDS/6panel includes
DATE-PLEASE INCLUDE INVOICE#ON CHECK
Submitted To
NOV 17 2014
Er Treasurer
__ C,,t..A n.t„m.with---t ���_
VOUCHER NO. WARRANT NO.
ALLOWED 20
IU Health Workplace Services, LLC
IN SUM OF$
2046 Reliable Pkwy
Chicago, IL 60686-0020
$52.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel HR Department
PO#/Dept. INVOICE NO. ACCT#/TITLE .• AMOUNT
Board Members
1201 I736754 I 43-588.00 I $52.00 I hereby certify that the attached invoice(s), or
bill(s) is (are)true and correct and that the
timaterials or services itemized thereon for
1
which charge is made were ordered and
received except
Monday, November 17, 2014
Director, HR
Title
1
Cost distribution ledger classification if.
claim paid motor vehicle highway fund
_ I
Prescribed by State Board of Accounts City Form No.,20.1(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)orbill(s))
11/03/14 736754 Onsite testing $52.00
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