332030 11/13/18 CITY OF CARMEL, INDIANA VENDOR: 00350735
ONE CIVIC SQUARE BOB VANVOORST CHECK AMOUNT: $*******196.25*
a9a CARMEL, INDIANA 46032 23402 MULE BARN ROAD CHECK NUMBER: 332030
SHERIDAN IN 46069 CHECK DATE: 11/13/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
301 5023990 11.07.18 196.25 OTHER EXPENSES
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
Vendor# 00350735 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
BOB VANVOORST IN SUM OF$ CITY OF CARMEL
23402 MULE BARN ROAD 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.
SHERIDAN, IN 46069
Payee
$196.25
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 $196.25 1 hereby certify that the attached invoice(s),or 11/7/18 11.07.18 Refund Premium Holiday for November and $196.25
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 distribution ledger classification if claim paid motor vehicle highway fund.
Clerk-Treasurer
INVOICE
On November 7, 201.8, the Board of Public Works approved a premium holiday for November
and December-20.1-8.. Please process November refunds from the Medical Escrow Fund(301) for -
the following retirees,.Whose monthly..contributions will be deducted automatically from their
PERF pension checks. li ted addresses ma, not be in the accounts ayable s, tem et
Return all checks to Barb Lamb in Human Resources. Thank you.
Brad Bartrom $235.50 P.O. Box 526,Carmel,IN 46.082
Mark Callahan-- $196.25 11 U80 East S+R 47, Sheridan, IN 4d®6.°
:Barry Crane $738.00 1U1 North Parker Avenue, Inde a olis, lN 4622
Leland:Goodman- $235.50 2.150 E 950 S, Flatrock, 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: 992 Vista del Norte,Payson,AZ 85541
Stephen Reeves $886.00 580 Barbee Lane, Indianapolis,:IN 46280.
Frank Vallone $8:86.00. .10707 Morristown Court; Carmel-46032
Robert VanVoorst $196.25 23402 Mule Barn Road, Sheridan,.FN 46069
Richard Viehe „ $429.11 2374 W. State Road-234, Fortville;IN 46040
Charles Whitaker . .$246..51 308 W. Haydn Drive,Apt 1318, Carmel;IN 47032
Alan Young $264.77 14295 Es°rit Drive, C el, IN 4f 07
NOV 13 2018