HomeMy WebLinkAbout326873 06/29/18 CITY OF CARMEL, INDIANA VENDOR: 370269
• ONE CIVIC SQUARE ZIRMED CHECK AMOUNT: $"*""*"*547.00"
r CARMEL, INDIANA 46032 1311 SOLUTIONS CENTER CHECK NUMBER: 326873
9y�TON :r CHICAGO IL 60677-1311 CHECK DATE: 06/29/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4355200 706370 298.00 SUBSCRIPTIONS
102 4467099 709670 249.00 OTHER EQUIPMENT
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
Vendor# 370269 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
ZIRMED IN SUM OF$ 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
$547.00
Purchase Order#
ON ACCOUNT OF APPROPRIATION FOR
Terms
Carmel Fire
Date Due
PO# ACCT# DATE INVOICE# DESCRIPTION
DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT
706370 43-552.00 $298.00 1 hereby certify that the attached invoice(s),or 6/20/18 706370 $298.00
1120 101 1120 101
709670 44-670.99 $249.00 bill(s)is(are)true and correct and that the 6/20/18 709670 $249.00
1120 1 1 102 1 materials or services itemized thereon for 1120 1 102
which charge is made were ordered and
received except
Wednesday,June 20,2018
U®r _
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
Clerk-Treasurer
y INVOICE Date 6/12/2018
Invoice# 1
Account#. 125101
25 12519101
For overnight or Due Date 7/12/2018
www.2iFe►�dtn.Ldhe correspondence ONLY: Customer PO#
Invoice questions?Please call(877)494-7633 ZirMed, Inc. Shipping Code(2)
option 4
Attn: Accounting Dept
.Email:,billinginquiry@zirmed.com 888 W..Market St., Ste 400- �c"
Customer Support or Sales:(877)494-7633 Louisville, KY 40202 Amount Paid
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-60671-1311
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125.191 ; Zirmed 709670 6/12/201.8; 7/12/2018
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i.MICR Check Reader-1553208 249.00 249.00-i
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Invoice Total ? $249.00
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547.00 224.00 : 0.00 0:00 . 0.00 $77.1.00
Would you like your invoice via email? Please email billinginquiry@zirmed.com
�, INVOICE DZvtoice# 7 18
06370
Account# 125191
For overnight or Due Date 7/12/2 7/12/2018
w1.vw.Z1aMF_U.Cr2M correspondence ONLY: Customer PO#
Invoice questions?Please.call(877)494-7633 ZirMed,.Inc. Shipping Code(2)
option 4 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-CivicSquareZirMed Inc.
Carmel IN 46032 1311 Solutions Center
Chicago, IL 60677-1311
125191 f 4` Zirmed 706370 6/12/2018', 7/12/2018
Monthly Professional Claims Management Fee 1 99.00 99.00 j
Monthly Eligibility System-Access Fee 1 100.00.; 100.00
Monthly Remittance Advice Access Fee 1 2500 - 25.00
Patient Payments-Virtual Terminal Fee 1 25.00 25:00
Patient Payments Ecommerce Monthly Portal Fee 1 49.00 49.00
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Invoice Total ; $298.001,
547.00 ' 224.00 4 0.00 0.00 0.00 $771.00 i
Would you like your invoice via email? Please email billinginquiry@zirmed.com