HomeMy WebLinkAbout314048 7/26/2017 >; CITY OF CARMEL, INDIANA VENDOR: 369550
ONE CIVIC SQUARE BRUCE GRAHAM CHECK AMOUNT: $*******400.00"
x ,r° CARMEL, INDIANA 46032 6299 HANOVER CT CHECK NUMBER: 314048
FISHERS IN 46038 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:
Bruce Graham
6299 Hanover Court
Fishers,IN 46038
Amount: $400.00
Fund: Medical Escrow Fund (301)
Date: July 24,2017
Subm '-ted To
JUL 2 5 2017
Clerk Treasurer