HomeMy WebLinkAbout327273 07/10/18 CITY OF CARMEL, INDIANA VENDOR: 370269
.;; ,• ONE CIVIC SQUARE ZIRMED
CHECK AMOUNT: $********24.00*
CARMEL, INDIANA 46032 1311 SOLUTIONS CENTER CHECK NUMBER: 327273
CHICAGO IL 60677.1311 CHECK DATE: 07/10/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4355200 696349 24.00 SUBSCRIPTIONS
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995)
ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
Vendor# 370269
ZIRMED IN SUM OF$ 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
$24.00
ON ACCOUNT OF APPROPRIATION FOR Purchase Order#
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
696349 43-552.00 $24.00 I hereby certify that the attached invoice(s),or 6/28/18 696349 Previous invoice was short paid on check# $24.00
1120 101 1120 101 325618.
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
Friday, June 29,2018
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 distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer
INVOICE Date 5/10/2018
Invoice# 696349
ZfRIVECYAccount# 125.191
wway.zir�MeQ,�oM For overnight or Due Date 6/9/2018
correspondence ONLY: Customer PO#
Invoice questions?Please call(877)494-7633 ZirMed, Inc.. Shipping Code(2)
option 4 Attn: Accounting Dept
Email:billinginquirya(zirmed.com 888 W.Market St., Ste 400
Louisville, KY 40202 Amount Paid
Customer Support or Sales:(877)494-7633
13111To 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
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125191 Zirmed 696349 5/10/2018 6/9/2018
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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
422.00 0.00 0.00 0.00 0.00 $422.00
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