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HomeMy WebLinkAbout318896 11/21/2017 •°'"Awf( �,; CITY OF CARMEL, INDIANA VENDOR: 370269 ONE CIVIC SQUARE ZIRMED CHECK AMOUNT: $***.*""224.00' _; s° CARMEL, INDIANA 46032 1311 SOLUTIONS CENTER CHECK NUMBER: 318896 7M CHICAGO IL 60677-1311 CHECK DATE: 11/21/17 ITON Gam' DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1120 4355200 635152 224.00 SUBSCRIPTIONS 0 n N < < S q 0 O K 2 g ) � 2 > « m0 n \ R ® 0 X 0 2 E < k E k \ 0 % CA ® q ® © q 0 0d m \ ^ } > / - \ 2 � 0 0 m \ � 2 R > - Q ; q oO ri o § (D ( / i 3 7 # z k $ g k { c 0 { A $ ƒ J i CD a » n o CL co f 3 f_ - E 3 � I 2 E § = _ CL o m _ E ƒ ' 3 % ¢ § M k / , \ 0 k k co E _ . « $ « E \ E CL a � < . * -4 ` - k ƒ N w E ( I a (D 7 � , - _c =r Q , y 7 �C 1 m a » \ k$ § j ) \ k ■ G J 3 i D / 0 \ 0 E § k o -n < ® 0OD ® C o 7 /} k § ) 2 k / ) / © a D /4 0 Z » } __q § C:) %L k k } | 0_00 > C31 0. � f }_ƒ CD \ §o & _ E > �E \ § k \ § f M n / j E _ \ \ 0 I 3 ± % ) / E 2 C } % $ / / 0 CL } \ CD / \ § k ® 7 E6 z k _ CD > } : ® o C z ° \ 12INVOICE Date 11110/2017 ZIJFRIVECY t# 12Invoice# 5152 Accoun5191 www.ZIXMeD.00M For overnight or Due Date 12/10/2017 correspondence ONLY: Customer PO# Invoice questions?Please call(877)494-7633 option 4 ZirMed, Inc. Attn: Accounting Dept Email:billinginquiry@zirmed.com 888 W.Market St., Ste 400 Louisville, KY 40202 Amount Paid Customer Support or Sales:(877)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 125191 Zirmed 635152 ? 11/10/2017 12/10/2017 Monthly Professional Claims Management Fee 1 99.00 j 99.00 1 Monthly Eligibility System Access Fee 1 100.00 100.001 Monthly Remittance Advice Access Fee 1 25.001 25.00 I � 1 1 i 1 ii I 1 i I ' � i i I i t Invoice Total $224.00 ---------------------------------- 11 11111 11 11111,111 1 1 I'llillillIll 224.00 ' 0.00 . 0.00 , 0.00 0.00 $224.00 __....__-_. Would you like your invoice via email? Please email billinginquiry@zirmed.com