HomeMy WebLinkAbout305710 11/28/16 ,Coq
CITY OF CARMEL, INDIANA VENDOR: 370269
it ONE CIVIC SQUARE ZIRMED CHECK AMOUNT: $*******224.00*
4 CARMEL, INDIANA 46032 1311 SOLUTIONS CENTER CHECK NUMBER: 305710
=9y�TON:r CHICAGO IL 60677-1311 CHECK DATE: 11/28/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4355200 513036 224.00 SUBSCRIPTIONS
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
ZIRMED ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
1311 SOLUTIONS CENTER IN SUM OF$ 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
ON ACCOUNT OF APPROPRIATION FOR Purchase Order#
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
513036 43-552.00 $224.00 1 hereby certify that the attached invoice(s),or 11/18/16 513036 $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
Friday, November 18,2016
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 distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer
API --- jipVNERN&9 INVOICE Date 11/10/2016
Invoice# 513036
It
Account# 125191
ZI .111
, 1 - A For overnight or Due Date 12/10/2016
correspondence ONLY: Customer PO#
Invoice questions?Please call(877)370-0050 ZirMed, Inc.
Email:billinginquiry@zirmed.com Attn: Accounting Dept
888 W.Market St.,Ste 400
Customer Support or Sales:(877)494-7633 Louisville, KY 40202 Amount Paid
Bill To PLEASE REMIT ONLY PAYMENTS
City of Carmel Fire Department TO THE FOLLOWING:
2 Civic Square ZirMed Inc.
Carmel IN 46032 1311 Solutions Center
Chicago, IL 60677-1311
---. .. . ...... .... ........ .. .......
AftMe
In
125191 Zirmed 513036 11/10/2016 12/10/2016
'Description
Monthly Professional Claims Management Fee 1 99.00 99.00
Monthly Eligibility System Access Fee 1 100.00 100.00
Monthly Remittance Advice Access Fee 1 25.00 25.00
ZirMed,Inc.Accounting Department phone number: (877) 370-0050 Invoice Total $224.00
Current 1-30 Days 3140 Days 61-90 Days Over 96 Days Account Balance
448.00 0.00 0.00 0.00 0.00 $448.00
Would you like your invoice via email? Please email billinginquiry@zirmed.com