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HomeMy WebLinkAbout327484 07/17/18 4y u,4,pM* J! � CITY OF CARMEL, INDIANA VENDOR: 370302 . �,• ONE CIVIC SQUARE VISION SERVICE PLAN CHECK AMOUNT: $****10,278.19* ,�� CARMEL, INDIANA 46032 PO BOX 742788 CHECK NUMBER: 327484 MdrSri�. LOS ANGELES CA 90074-2788 CHECK DATE: 07/17/18 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 301 5023990 07.02.18 10,278.19 OTHER EXPENSES VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) Vendor# 370302 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER VISION SERVICE PLAN IN SUM OF$ 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 $10,278.19 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 07.02.18 50-239.90 $10,278.19 1 hereby certify that the attached invoice(s),or 7/2/18 07.02.18 July 2018 $10,278.19 301 301 301 301 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 Thursday,July 12,2018 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 distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer WIMI Page 1 i 1 • Account Number: 12 013661 0001 VS Bill Print Date: JULY 02, 2018 For JULY 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 $10,302.38 Payments/Billing Adjustments 410,302.38 -- - -- _ --- --- Outstanding-Receivable Totai - - $0.00 Current Billing Period Activity Current Charges $10,278,19 Please Pay This Amount $10,278.19 31 ©ays 8 B1 ©ays 62 91 Days >32©ays fix ' ' $t t?,27�t 9 $�?i�fl $f3 fl0 $(1 t30 JUL 10 2018 Clare Treasurer Questions? Please call 1-866-213-2249 if you have questions regarding your bill or membership. Pasrarz forpecpf Urfa far fife