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HomeMy WebLinkAbout327617 07/18/18 o`%�� � CITY OF CARMEL, INDIANA VENDOR: 00350846 / ONE CIVIC SQUARE KIMBERLY K. PRATT CHECK AMOUNT: $*******400.00* s i?� CARMEL, INDIANA 46032 1063 ARROWWOOD DRIVE CHECK NUMBER: 327617 ;ETON�°` CARMEL IN 46033 CHECK DATE: 07/18/18 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 301 5023990 07.10.18 400.00 OTHER EXPENSES VOUCHER NO. WARRANT NO. Prescribed by state Board of Accounts City Form No.201(Rev.1995) Vendor# 00350846 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER KIMBERLY K. PRATT IN SUM OF$ CITY OF CARMEL 1063 ARROW W OOD DRIVE 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. CARMEL, IN 46033 Payee $400.00 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 07.10.18 50-239.90 $400.00 1 hereby certify that the attached invoice(s),or 7/10/18 07.10.18 Bi-Annual Health Savings Account $400.00 301 301 301 301 Contribution 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 City of Carmel Employee Health Benefit Plan Health Savings Account Incentive The retired plan participant listed below has elected Plan A for 2018 and is eligible for a bi- annual contribution to his or her HSA account, as authorized by Resolution BPW-10-03-12-02. Clerk-Treasurer: Please return check to Human Resources for distribution. Plan Participant/Payee: Kimberly Pratt 1063 Arrowwood Drive Carmel, IN 46033 Amount: $400.00 Fund: Medical Escrow Fund(301) Date: July 10,2018 :ub1t ed TO 1 1 2018Cr surer