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HomeMy WebLinkAbout252988 01/11/16 1 r 4,p*f a�`� �� CITY OF CARMEL, INDIANA VENDOR: 364990 ® i. ONE CIVIC SQUARE C H C WELLNESS CHECK AMOUNT: $*****1,700.00* s. ?Q CARMEL, INDIANA 46032 5440 N CUMBERLAND AVE#225 CHECK NUMBER: 252988 9.i;,��oN�` CHICAGO IL 60656 CHECK DATE: 01/11/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 301 5023990 C3181.01 1,700.00 OTHER EXPENSES VOUCHER NO. WARRANT NO. ALLOWED 20 C H C WELLNESS 5440 N CUMBERLAND AVE#225 IN SUM OF$ CHICAGO, IL 60656 $1,700.00 ON ACCOUNT OF APPROPRIATION FOR 30 PO#/Dept. INVOICE NO. I ACCT#/Fund AMOUNT Board Members 301 I C3181.01 I 110-100.00 I $1,700.00 1 hereby certify that the attached invoice(s), or 301 Prior Year 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, January 04, 2016 Cost distribution ledger classification if claim paid motor vehicle highway fund 5440 N. Cumberland Ave., Suite 225 INVOICE © Chicago, IL 60656 TEL: 847.640.4440 Invoice# C3181.01 WELLNESS FAX: 847.437.2770 1111ft— _9A www.chcw.com Date 12/10/2015 Ship 12/9/2015 Bill To Terms Net 30 City of Carmel Re Ron Attn:Barbara Lamb p -7 1 Civic Square Carmel,IN 46032 � ,� €0; ® Due Date 1/9/2016 JAN 0 4 2W r auger Quantity Item Code Description Price Each Amount Wellness Screenings for City of Carmel Employees Not On Company BAS PPO Plan 1 H&W-Company Health&Wellness-City Of Carmel Water Operations- 11/10/2015 170.00 170.00 -Brett Ransford 2 H&W-Company Health&Wellness-Carmel City Hall- 11/12/2015 170.00 340.00 -Camille Nelsen -Lisa Motz 6 H&W-Company Health&Wellness-Carmel City Hall- 11/18/2015 170.00 1,020.00 -Sue Finkam -William Giles -Lisa Stewart -Marguerite Crediford -Carolyn Schleif -Catherine Schoenherr I H&W-Company Health&Wellness-Remote Ending- 12/02/2015 170.00 170.00 -Preston Stacy Thank you for your business. Invoice Total $1,700.00 PLEASE MAKE CHECK PAYABLE TO: CHC WELLNESS payments/Credits $0.00 REMITTANCE ADDRESS: 5440 NORTH CUMBERLAND AVE., SUITE 225 Balance Due $1,700.00 CHICAGO, IL 60656