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HomeMy WebLinkAbout308722 02/28/17 G�q ��`' '�f• CITY OF CARMEL, INDIANA VENDOR: 369550 ONE CIVIC SQUARE BRUCE GRAHAM CHECK AMOUNT: $*******400.00* CARMEL, INDIANA 46032 6299 HANOVER CT CHECK NUMBER: 308722 FISHERS IN 46038 CHECK DATE: 02/28/17 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 301 5023990 02.23.17 400.00 OTHER EXPENSES VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) Vendor# 369550 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER BRUCE GRAHAM IN SUM OF$ CITY OF CARMEL 6299 HANOVER CT 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. FISHERS, IN 46038 Payee $400.00 Purchase Order# ON ACCOUNT OF APPROPRIATION FOR 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 1 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: Bruce Graham 6299 Hanover Court Fishers,IN 46038 Amount: $400.00 Fund: Medical Escrow Fund (301) Date: February 23,2017