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HomeMy WebLinkAbout253586 01/22/16 i CITY OF CARMEL, INDIANA VENDOR: 370241 y \l ONE CIVIC SQUARE BENEFIT PLANNING CONSULTANTS INCr-HECK AMOUNT: S""'1,234.70* s, ?� CARMEL, INDIANA 46032 PO BOX 7500 CHECK NUMBER: 253586 9'�l,�tONiL,'pi� CHAMPAIGN IL 61826.7500 CHECK DATE: "01/22/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 301 5023990 BPCIO0111153 1,234.70 OTHER EXPENSES Invoice #BPCI00111153 3J1 -41*, Date: January 12, 2016 ' CITY OF CARMEL 's® Account: Benefits Invoice #: '=' SOCI00'11iri's4 Previous Balance: $0.00 CITY OF CARMEL 1 CIVIC SQUARE This Invoice: $1,234.70 CARMEL, IN 46302 Other Invoices/Credits: $0.00 Account Balance: $1,234.70 Remit Payment To: _Benefit Planning_CQnsultants-Inc __ . __._ _Due Date_ _ 02/05/-2016 _ PO Box 7500 Late Fee: 9.75% APR Champaign, IL 61826-7500 0.81%/Month Comments: Monthly administration for the month of February 2016 g Ulm Monthly,Flex Services $3.45 Per Participant, 93 $32q.85: Monthly COBRA Services $0.50 Per Qual Elig. EE 593 $296.50 Monthly Flex Services January $3.45 Per Participant 93 V20.85 Monthly COBRA Services - January $0.50 Per Qual Elig. EE 593 $296.50 :Thisinvoice Tota/: $1,234b70: Clerk 'Treasurer Total Now Due: $1,234.70 Questions? Call Toll-Free (800) 355-2350 or e-mail.billing@bpcinc.com Benefit Planning Consultants,Inc.;2110 Clearlake Blvd.Suite 200;P.O.Box 7500;Champaign,IL 61826-7500 Prescribed by State Board of Accounts � ACCOUNTS PAYABLE VOUCHER City Forth No.201(Rev.1995) 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 Benefit Planning Consultants, Inc Purchase Order No. PO Box 7500 Terms Champaign, IL 61826-7500 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 1,234.70 - Total 1,234.70 1 hereby certify that the attached invoice(s), or bill(s), is (are)true and correct and I have audited same in accor- dance with IC 5-11-10-1.6. 20 Clerk-Treasurer VOUCHER NQujg 1s WARRANT NO. ALLOWED 20 Benefit Planning Consultants, Inc IN SUM OF $ PO Box 7500 Champaign, IL 61826-7500 ON ACCOUNT OF APPROPRIATION FOR 3©1 (Uledi ca�liFu101f Board Members PO#or INVOICE NO. ACCT#/TITLE AMOUNT DEPT.# I hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and that BPCI00111153 301 1,234.70 j the materials or services itemized thereon for which charge is made were ordered and received except I i 20 Signature Cost distribution ledger classification if Title claim paid motor vehicle highway fund