HomeMy WebLinkAbout332181 11/13/18 CITY OF CARMEL, INDIANA VENDOR: 367222
® �( ONE CIVIC SQUARE IU HEALTH WORKPLACE SERVICES LLCCHECK AMOUNT: $*******941.05*
CARMEL, INDIANA 46032 2046 RELIABLE PKWY CHECK NUMBER: 332181
CHICAGO IL 60686-0020 CHECK DATE: 11/13/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1205 4347500 764237 941.05 GENERAL INSURANCE
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
Vendor# 367222 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
IU HEALTH WORKPLACE SERVICES LLC IN SUM OF$ CITY OF CARMEL
2046 RELIABLE PKWY 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.
CHICAGO, IL 60686-0020
Payee
$941.05
ON ACCOUNT OF APPROPRIATION FOR Purchase Order#
General Administration Terms
Date Due
PO# ACCT# DATE INVOICE# DESCRIPTION
DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT
764237 43-475.00 $941.05 1 hereby certify that the attached invoice(s),or 10/31/18 764237 Oct 2018 EAP Services $941.05
1205 101 1205 101
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
Monday, November 5,2018
Crider,James
Administration
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
Indiana University Health Workplace Services,LLC 1(s
714 N.Senate Avenue
Suite 200
Indianapolis, IN 46202
317-963-1535
Tax ID# 20-0994452
Invoice
October 31, 2018
Bill to: Barbara Lamb For: City of Carmel-Onsite
City of Carmel-Onsite EAP Services/Oct.2018
1 Civic Square
Carmel,IN 46032-
Invoice# 764237
Service Date Descri tl�ion Quanti Charge Recei Aw-u—st Balance
10/01/2018 EAP Services 649.00 941.05 941.05
CITYCARO Invoice# 764237 Balance Due: 941.05
MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE
INVOICE#ON CHECK
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NOV 0 5 2018 L_ fl
Cla Gov
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