HomeMy WebLinkAbout303585 09/26/16 ,0 CITY OF CARMEL, INDIANA VENDOR: 370269
ONE CIVIC SQUARE ZIRMED CHECK AMOUNT: $**'****224.00*
CARMEL, INDIANA 46032 1311 SOLUTIONS CENTER CHECK NUMBER: 303585
CHICAGO IL 60677-1311 CHECK DATE: 09/26/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4355200 493504 224.00 SUBSCRIPTIONS
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995)
ZIRMED ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
1311 SOLUTIONS CENTER IN SUM OF$ CITY OF CARMEL
An invoice or bill to be properly itemized must show:kind of service,where performed,dates service
CHICAGO, IL 60677-1311 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
$224.00 Payee
Purchase Order#
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Terms
Date Due
PO# ACCT# DATE INVOICE# DESCRIPTION
DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT
493504 43-552.00 $224.00 1 hereby certify that the attached invoice(s),or 9/21/16 493504 $224.00
1120 101 1120 101
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
Wednesday, September 21,2016
David Haboush
Fire Chief
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—
Cost
20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer
125191 Zirmed 493504 9/13/2016 10/13/2016
Monthly Professional Claims Management Fee 1 99.00 t 99.00
Monthly Eligibility System Access Fee 1 100.00. 100.00
Monthly Remittance Advice Access Fee 1 25.00 25.00
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ZirMed, Inc.Accounting Department phone number: (877) 370-0050 Invoice Total $224.00
224.00 0.00 0.00 0.00 0.00 $224.00
Would you like your invoice via email? Please email billinginquiry@zirmed.com