HomeMy WebLinkAbout314031 7/26/2017 CITY OF CARMEL, INDIANA VENDOR: 036500 CHECK AMOUNT: $ k R R R t»400.00*
ONE CIVIC SQUARE LUCKIE A. CAREY CHECK NUMBER: 314031
WESTFIELD
rQ CARMEL, INDIANA 46032 WELD I P CIRCLE
IN 46074 CHECK DATE: 07/26/17
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
301 5023990
07 .24 .17 400.00 OTHER EXPENSES
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City of Carmel Employee Health Benefit Plan
Health Savings Account Incentive
The retired plan participant listed below has elected Plan A for 2017 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:
Luckie Carey
523 Windskip Circle
Westfield,IN 46074
Amount: $400.00
Fund: Medical Escrow Fund (301)
Date: July 24,2017
SubM =`ted To
JUL 2 5 2017
Clerk Treasurer