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HomeMy WebLinkAbout308716 02/28/17 <'1y,ur 4�gMft CITY OF CARMEL, INDIANA VENDOR: 00351349 t=: ONE CIVIC SQUARE DOUGLAS CALLAHAN CHECK AMOUNT: $*******400.00* s. ?4 CARMEL, INDIANA 46032 1015 EAST 106TH STREET CHECK NUMBER: 308716 INDIANAPOLIS IN 46280 CHECK DATE: 02/28/17 iTON.�O' DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 301 5023990 02.23 .17 400.00 OTHER EXPENSES VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) Vendor# 00351349 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER DOUGLAS CALLAHAN IN SUM OF$ CITY OF CARMEL 1015 EAST 106TH STREET An invoice or bill to be property 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. INDIANAPOLIS, IN 46280 Payee $400.00 ON ACCOUNT OF APPROPRIATION FOR Purchase Order# 301 Medical Fund Terms 301 Medical Fund Date Due PO# ACCT# DATE INVOICE# DESCRIPTION DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT 02.23.17 50-239.90 $400.00 I hereby certify that the attached invoice(s),or 2/23/17 02.23.17 Bi-Annual Contribution Health Savings Acct $400.00 301 301 301 301 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 Tuesday, February 28,2017 Lamb, Barbara Director 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 City of Carmel Employee Health Benefit.Plan Health Savings Account Incentive The retired plan participant listed below has elected Plan A for 2016 and is eligible for a bi- annual contribution to his or her HSA account, as authorized by Resolution BPW-10-03-12-02. Payroll: Please return check to Human Resources for distribution. Plan Participant/Payee: Douglas Callahan 1015 East 106th Street Indianapolis,IN 46280 Amount: $400.00 Fund: Medical Escrow Fund (301) Date: February 23,2017