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332031 11/13/18
�A+, CITY OF CARMEL, INDIANA VENDOR: 00353232 ® ONE CIVIC SQUARE RICK VIEHE CHECK AMOUNT: $*******429.11 s� �a CARMEL, INDIANA 46032 2374 WEST STATE RD 234 CHECK NUMBER: 332031 ��1TUN G� FORTVILLE IN 46040 CHECK DATE: 11/13/18 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 301 5023990 11.07.18 429.11 OTHER EXPENSES VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) Vendor# 00353232 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER RICK VIEHE IN SUM OF$ CITY OF CARMEL 2374 WEST STATE RD 234 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. FORTVILLE, IN 46040 Payee $429.11 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 $429.11 1 hereby certify that the attached invoice(s),or 11/7/18 11.07.18 Refund Premium Holiday for November and $429.11 301 301 301 301 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;2018, the Board of Public Works approved a premium holiday for.November and December 2018. Please process November,refunds from the Medical EseroW Fund(301) for the following retirees,.Whose monthly.co 'butions will be-deducted automatically from their. PERF.pension_checks: . ighli ted addresses ma, not be in the accounts a. able system et. Return all checks to Barb Lamb in Human Resources. Thank you.' Brad Bartrorn . .$235.50 P:O. Box 526; Carmel, IN 46082 Mark Callahan . $196.25 11 U8U East S+R 47, Sheridan,IN 4f 06' Barry Crane :. $738:00 101 North Parker Avenue, Indiana ©lis, IN 4522 : Leland Goodman $235.50 2150 E 950 S, Flatrock, IN 47234 Timothy Green. $886.0.0 11468 Senie Lane, Carmel. IN 46032 David Mead $886.00 1511 Queensborough Drive,.-Carmel,IN 46033 Donald Mead $886:00vI992 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-46052. . Robert VanVoorst $196.25: 23402 Mule.Barn Road, Sheridan,IN 4.6069 Richard Viehe $429.11 : 2374 W. StateRoad234,Fortville, IN 46040. Charles Whitaker $246:5.1 308 W. Haydn-Drive, Apt-1318, Carmel;IN 47032 AlanYoung $264.77 14295 Es rit Drive, Carmel, �N 4507 y NOV 13 2018 - - y