333354 12/14/18 ® i• CITY OF CARMEL, INDIANA VENDOR: 00353232
ONE CIVIC SQUARE RICK VIEHE CHECK AMOUNT: $*******429.11*
sp\�roN=? CARMEL, INDIANA 46032 FORTVI LE INT4 040 EST STATE RD 234 CHECK CHECK DATE: : 333354
12/14/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
301 5023990 12.13.18 429.11 OTHER EXPENSES
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
Vendor# 00353232 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
RICK VIEHE IN SUM OF$ 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
12.13.18 50-239.90 $429.11 1 hereby certify that the attached invoice(s),or 12/13/18 12.13.18 Refund Premium Holiday for December $429.11
301 301 301 301
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, December 13,2018
/Ali-"— 7c" �
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
The Board of Public Works and Safety has approved a premium holiday for November and
December 2018. Please process December refunds from the Medical Escrow Fund(301) for the
following retirees,whose monthly contributions will be deducted automatically from their PERF
pension checks.
Return all checks to Barb Lamb in Human Resources.
Brad Bartrom $235.50 P.O. Box 526, Carmel, IN 46082
Mark Callahan $196.25 11080 East SR 47, Sheridan, IN 46069
Barry Crane $738.00 6101 North Parker Avenue, Indianapolis, IN 46220
Leland Goodman $235.50 2150 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 7992 Vista del Norte,Payson,AZ 85541
Stephen Reeves $886.00 580 Barbee Lane, Indianapolis, IN 46280
Frank Vallone $886.00 10707 Morristown Court, Carmel 46032
Robert VanVoorst $196.25 23402 Mule Barn Road, Sheridan, IN 46069
=&RichardViehe $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 Esprit Drive, Carmel, IN 46074
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DEC 13 2018
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