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309165 03/14/17 �r_c�,yf CITY OF CARMEL, INDIANA VENDOR: 370302 ♦ ONE CIVIC SQUARE VISION SERVICE PLAN CHECK AMOUNT: $"""9,912.52' CARMEL, INDIANA 46032 PO BOX 742788 CHECK NUMBER: 309165 M,i toN�°. LOS ANGELES CA 90074-2788 CHECK DATE: 03/14/17 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 301 5023990 03 .01.17 9,912.52 OTHER EXPENSES 0 r -0 < < « k w m � O d o @ � O 9 e CL � # 2 > O k ° 0 ƒ ^ 0 G) v M ^ rn q m .06 (4 X m % < 0 2 E 2 C U) $ G O 1 \ § o C ® > m Q C ( D co d 0 CA� cD - -n -nq q / =i; § § E 0 c C - m 3 © ^ k ° � 2 2 z 2 4 _ > O ; 7 § 3 C z z © ® z e I o ^ c § ` � 0) l< § K ƒ f ) 0 ? n o q ƒ i _ E q - ® / « 3 / / ca ( k T m . § CD $ / 8 CD 7 m CD F CD / K) C C } 7 -4 } % k a § C ± ƒ ) CD 0 c( a k 7 w e m o cr CD \ 7 k em f 2 i - G n � # � - M ) k \ E D / .« 0C E 0k g -n < a ° 0 CD C ? ƒkCD R ) / ^/ D C) Z ( _ o %E k k § | �0 _0 ° , \ f_ƒ (D =r D � ( \ \ « . ;u 0 z -0 :j o H # m G n 2 f o m ° c § i 0 f $ ] CDi E % ¢ \ G $ / 0 n CLk 2 8 ] CD k F C? \ 7 K \ s ƒ / 2 » Page 1 VS Account Number: 12 013661 0001 e Bill Print Date: MARCH 01, 2017 For MARCH 2017 Membership Received After: The 15th of the month will reflect on your next bill. Payment Due Date: Upon receipt of this bill CITY OF CARMEL C/O BARBARA LAMB 1 CIVIC SQUARE CARMEL IN 46032-2584 Prior Billing Period Activity Amount Previously Billed $19,775.27 Payments/Billing Adjustments -$19,775.27 Outstanding Receivable Total $0.00 Current Billing Period Activity Current Charges $9,912.52 Please Pay This Amount $9,912.52 I-31 Days 32.61 Days' 62.91 Days >92 Days $9,912.52 $0.00 $0.00 $0.00 Submitted To MAR 13 2017 Clerk Treasurer Questions? Please call 1-866-213-2249 if you have questions regarding your bill or membership. Passion for people. Vision for life. :'" How to Read the First Page of Your Billing Statement • • 1 This billing statement 1 Pagel VSP- includes membership Account Number. 110000000001 processed by VSP Bill Print Date August 18,2000 For September 2000 through the date Membership Processed After: The 15th of the month will reflect on your next bill. 6 Messages regarding displayed here. Payment Due Date: Upon receipt of this statement your payment, billing statement,or Sample Bill membership,if any. Employee Benefits Department 2 Prior Billing Period Activity $57.00 2 Amount billed on the 1234 Quality Circle Amount Previously Billed -$40.00 last billing statement. Anywhere,CA 98560-4855 3 Payments/Billing Adjusments -$5.00 Outstanding Receivable Total $12.00 Current Billing Period Activity 7 VSP contact information for billing 3 Manually processed 4 currentcnarges $s2.00 and membership adjustments since Please Pay This Amount $64.00 questions. your last billing o- statement. C s1[)ays 32-sl Days 62-91 Days >92days- •7 $62'00 $6'100 $7'00 $0'00 8 Please complete and return the payment coupon to the VSP Total charges for this address on the 4 billing cycle. 6 VSP appreciates your business. bottom of the billing statement. 9 Total charge/amount due 5 Outstanding receivable 7 for this billing cycle. detail section. 1 Passion for People.VisionforLife. ....................................................................................................................................... Please detach and realm this portico vOth your payment Total number of Bill Print Date:August 18,2000 For September 2000 10 memberslemployees paid Group Name: Sample Bill Attn:Karen D.Service for this billing cycle. Account Number(s): 11 000000 0001 $ Return To: 9 Amount Due $84.00 VSP-(CA) mount Paid $ P.O.Box 45210 San Francisco,CA 94145-5210 10 Number Paid for