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HomeMy WebLinkAbout333484 12/14/18 a., 1CITY OF CARMEL, INDIANA VENDOR: 372019 �( ONE CIVIC SQUARE EBIX BENEFITS CHECK AMOUNT: $*******141.50* � j�� CARMEL, INDIANA 46032 P.O.BOX 263 CHECK NUMBER: 333484 b,�TON�o. CHELSEA AL 35043 CHECK DATE: 12/14/18 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1201 4345000 617729 141.50 PRINTING (NOT OFFICE VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) Vendor# 372019 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER EBIX BENEFITS IN SUM OF$ CITY OF CARMEL P.O. BOX 263 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. CHELSEA, AL 35043 Payee $141.50 Purchase Order# ON ACCOUNT OF APPROPRIATION FOR Human Resources 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 617729 43-450.00 $141.50 1 hereby certify that the attached invoice(s),or 12/11/18 617729 $141.50 1201 101 1201 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 Wednesday, December 12,2018 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 BENEFITS ADMINISTRATION 2 EBIXAND WELLNESS Invoice Thank you for your order!Payment is due upon receipt. Jim Spelbring Invoice Date 11/28/2018 City of Carmel Invoice No. 617729 1 Civic Sq Carmel, IN 46032 P.O.Number Customer No. 202254 Client Number Sales Rep 202 Item - -Item Description - Quanti---- —Rate--y — Item otT a�`— 1HC19GE1 2019 Celebrate Wellness 50 @ $2.45 = $122.50 Subtotal $122.50 Shipping&Handling $19.00 Sales Tax/GST $0.00 Total $141.50 Please return bottom portion with payment. Payment/Credits $0.00 A publication of Ebix,Inc. PO Box 263,Chelsea,AL 35043 Total Due $141.50 Our Fed/Tax ID#:77-0021975 To charge to VISA,MC,AMEX,Discover call(800)871-9525 or enter information below and fax or mail back in provided envelope.