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HomeMy WebLinkAbout320651 01/11/18 CITY OF CARMEL, INDIANA VENDOR: 370302 ONE CIVIC SQUARE VISION SERVICE PLAN CHECK AMOUNT: $****10,193.95* ,4 CARMEL, INDIANA 46032 PO BOX 742788 CHECK NUMBER: 320651 9.y�rON, LOS ANGELES CA 90074-2788 CHECK DATE: 01/11/18 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 301 5023990 01.02.18 10,193.95 OTHER EXPENSES VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) ALLOWED 20 ACCOUNTS PAYABLE VOUCHER Vendor# 370302 VISION SERVICE PLAN IN SUM OF$ CITY OF CARMEL PO BOX 742788 An invoice or bill to be properly itemized must show:kind of service,where performed,dates service rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc. LOS ANGELES, CA 90074-2788 Payee $10,193.95 Purchase Order# ON ACCOUNT OF APPROPRIATION FOR 301 Medical Fund Terms 301 Medical Fund Date Due PO# ACCT# DATE INVOICE# DESCRIPTION DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT 01.02.18 50-239.90 $10,193.95 1 hereby certify that the attached invoice(s),or 1/2/18 01.02.18 Jan 2018 $10,193.95 301 301 301 301 bill(s)is(are)true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except Tuesday,January 09,2018 Lamb, Barbara Director I hereby certify that the attached invoice(s),or bill(s),is(are)true and correct and I have audited same in accordance with IC 5-11-10-1.6 ,20— Cost 20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer Page 1 • 1 Account Number: 12 013661 0001 VS Bill Print Date: JANUARY 02, 2018 For JANUARY 2018 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 $10,318.36 Payments/Billing Adjustments -$10,318.36 Outstanding Receivable Total $0.00__ , Current Billing Period Activity Current Charges $10,193.95 Please Pay This Amount $10,193.95 ix a'`" a'` :la's #f0 > >: Questions? Please call 1-866-213-2249 if you have questions regarding your bill or membership. ............ P��.:rarr,......c�:......:... ..:Q:.::.:...::.. ........:..........:.....