HomeMy WebLinkAbout321247 01/25/18 CITY OF CARMEL, INDIANA VENDOR: 370269
ONE CIVIC SQUARE ZIRMED CHECK AMOUNT: $**"'**224.00*
CARMEL, INDIANA 46032 13 1 1 SOLUTIONS CENTER CHECK NUMBER: 321247
9y�roN,�° CHICAGO IL 60677-1311 CHECK DATE: 01/25/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4355200 655760 224.00 SUBSCRIPTIONS
VOUCHER NO. WARRANT NO. Prescribed by state Board of Accounts City Form No.201(Rev.1995)
ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
Vendor# 370269
ZIRMED IN SUM OF$ CITY OF CARMEL
1311 SOLUTIONS CENTER 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.
CHICAGO, IL 60677-1311
Payee
$224.00
Purchase Order#
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Terms
Date Due
PO# ACCT# DATE INVOICE# DESCRIPTION
DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT
655760 43-552.00 $224.00 1 hereby certify that the attached invoice(s),or 1/22/18 655760 $224.00
1120 101 1120 101
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
Monday,January 22,2018
v4mDr '-ZS
David Haboush
Fire Chief
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
Zir*d Accoode - e • - !. - 1 -D.
125191 Zirmed 655760 1/11/2018 2/10/2018
P -
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
nt e ®. -OG ®. 90 ®. Over •o Days AccountBaLance
448.00 0.00 0.00 0.00 0.00 $448.00
Would you like your invoice via email? Please email billinginquiry@zirmed.com