HomeMy WebLinkAbout180968 12/30/2009 e� i i CITY OF CARMEL, INDIANA VENDOR: 295900 Page 1 of 1
i. i ONE CIVIC SQUARE ST VINCENT HOSPITAL
CARMEL, INDIANA 46032 EAR CHECK AMOUNT: $218.55
s�-_ 8401 HARCOURTROAD CHECK NUMBER: 180968
INDIANAPOLIS IN 46260
CHECK DATE: 12/30/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4340700 53672895 218.55 MEDICAL FEES
11 St. Vincent Stress Centers AIR Account 3 -1000- 1130 -00
Rate No. of Employees
ST. VINCENT STRESS CENTER $2.35 31
ST. VINCENT EAP
8401 Harcourt Road
INDIANAPOLIS, IN 46260
Date Description Units Amount
October EAP Services 1 $72.85
2009
November EAP Services 1 $72.85
2009
December EAP Services 1 $72.85
2009
Purchase
Description naY/ y ARP O,4 .IU''v t
P.O. P or F
01.11 115 �3 6 7 6 0
unel /222d I fee
Una escr
Purchaser
Approval_,,. Date e- 1
Total $218.55
For questions regarding this bill please call (317) 338 -4900.
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of 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.
Payee
Purchase Order No.
295900 St. Vincent Stress Center Terms
8401 Harcourt Road Date Due
Indianapolis IN 46260
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
10/9/09 53672895 Employee Assistance Program Oct,Nov,Dec 218.55
Total 218.55
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
Clerk- Treasurer
Voucher No. Warrant No.
295900 St. Vincent Stress Center Allowed 20
8401 Harcourt Road
Indianapolis IN 46260
In :Sum of
218.55
ON ACCOUNT OF APPROPRIATION FOR
101 General Fund
PO# or Board Members
INVOICE NO. ACCT TtTLE AMOUNT
#1
Dept
1125 53672895 4340700 218.55
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
23 -Dec 2009
A d/7A it/192/7MA
Signature
218.55 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund