HomeMy WebLinkAbout311943 05/30/17 9, )
CITY OF CARMEL, INDIANA VENDOR: 370269
ONE CIVIC SQUARE ZIRMED CHECK AMOUNT: S*******224.00*
CARMEL, INDIANA 46032 1311 SOLUTIONS CENTER CHECK NUMBER: 311943 CHICAGO IL 60677-1311 CHECK DATE: 05/30/17
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4355200 576018 224.00 SUBSCRIPTIONS
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INVOICE Date 5/10/2017
Invoice# 576018
ZIK Lj Account# 125191
Wwwz kmt�'UL:Um For overnight or Due Date 6/9/2017
correspondence ONLY: Customer PO#
Invoice;:uestions?Please call(877)494-7633
option 4 ZirMed, Inc.
Attn: Accounting Dept
Ew9ii:billinginquiry@zirmed.com 888 W.Market St., Ste 400
Louisville, KY 40202 Amount Paid
Customer Support or Sales:(8 ?)494-7633
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
ZrMed . _ D. -pup_Qate
125191 Zirmed 576018 5/10/2017 6/9/2017
Description Qty Price Total
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
Invoice Total $224.00
Current 1-30 Days 31-60 Days 61-90 Days Over 90 Days Account Balance
448.00 0.00 7
0.00 0.00 0.00 $448.00
Would you like your invoice via email? Please email billinginquiry@zirmed.com