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332022 11/13/18
CITY OF CARMEL, INDIANA VENDOR: 370505 ONE CIVIC SQUARE DON R. MEAD JR. CHECK AMOUNT: $*******886.00* CARMEL, INDIANA 46032 640 N.RANGELINE ROAD CHECK NUMBER: 332022 M?roN c� CARMEL IN 46032 CHECK DATE: 11/13/18 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 301 5023990 11.07.18 886.00 OTHER EXPENSES VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) Vendor# 370505 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER DON R. MEAD JR. IN SUM OF$ CITY OF CARMEL 640 N. RANGELINE ROAD An invoice or bill to be property 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 46032 Payee $886.00 ON ACCOUNT OF.APPROPRIATION FOR Purchase Order# 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 11.07.18 50-239.90 $886.00 1 hereby certify that the attached invoice(s),or 11/7/18 11.07.18 Refund Premium Holiday for November and $886.00 301 301 301 301 December 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 Tuesday, November 13,2018 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 20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer INVOICE On November 7, 2018, the Board of Public Works approved a premium holiday for November and December 2018. Please process November refunds from the Medical Escrow Fund'(301)for the.following retirees .whose monthly contributionswill be:deducted automatically from their. PERF pension checks. : i li ted addresses mat not be in the accounts a, able s stem et Return all checks to Barb Lamb in Human Resources. Thank you. . Brad Bartrom $23:5.50 P.O. Box 526, Carmel, IN 46082 Mark Callahan $196.25. 11©80 East SR 47, Sheridan, IN 4506.' BqM Crane $738.00 6101 North Parker Avenue, Indiana o1s, 1N 4622 .Leland Goodman $235.50 2150 E 950 S, Fl4trock;IN 47234 Timothy Green $886.00-- . 11468 Senie Lane, Carmel. IN 46032 David Mead $886.00 1511:Queensborough Drive, Carmel, IN 46033 Donald Mead $886.00: 7992 Vista del Norte,Payson,AZ 85541 Stephen Reeves $886:00 580 Barbee;Lane, Indianapolis, IN 46280 Frank Vallone $886.00 10707:Morristown Court; Carme146032 Robert.VanVoorst $196.25 23402 Mule Barn Road, Sheridan, IN 46069 Richard Viehe $429.11 . 2374 W. State Road 234,Fortville, IN 46040.' Charles Whitaker- $246.51 308 W. Haydn Drive, Apt 1-318; Carmel, IN 47032 AlanYoung $264.77. i 4295 Es rit Drive, Carmel, ITt 4507 NOV 1 3 2018 r i'