184942 04/27/2010 CITY OF CARMEL, INDIANA VENDOR: 295900 Page 1 of 1
ONE CIVIC SQUARE ST VINCENT HOSPITAL
CARMEL, INDIANA 46032
EAP CHECK AMOUNT: $218.55
8401 HARCOURT ROAD CHECK NUMBER: 184942
INDIANAPOLIS IN 46260
CHECK DATE: 4/27/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4340700 54272566 218.55 MEDICAL FEES
�St. Vincent Stress Centers
S
ST. VINCENT�STRESS CENTER.�� Amount Due: $218.55
ST. VINCENT EAP Amount Paid:
8401�Harcourt'Road''.
I NDIANAP`OL" IS, CN'46260
A/R Account 3- 1000 1130 -00
Date Account Number
1/15/10 5- 20386066
Invoi #064272566
Carmel Clay Parks Recreation
Attn: Lynn Russell
1411 E. 116` Street
Carmel, IN 46032
To ensure proper credit to your account, please enclose top portion of this invoice with your payment.
li w St. Vincent Stress Centers A/R Account 3 -1000- 1130 -00
Rate No. of Employ
ST. VINCENT STRESS CENTER $2.35 31
ST. VINCENT EAP
8401 Harcourt Road
INDIANAPOLIS, IN 46260
Date Description Units Amount
March EAP Services 1 $72.85
2010
April EAP Services 1 $72.85
2010
'a, 3'May EAP Services 1 $72.85''--
2010
Purchase E -AF' AWN+fnA
F.O. I PorF APR 2 0 2010
Llne �x_l �M
Purchaser__ Date
Apy ruvsi_ ats0 Total '$21$.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
1115110 54272566 Employee Assistance Program Mar,Apr,May 218.55
Total 218.55
1 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
1 20
Clerk- Treasurer
Voucher No. Warrant No.
29_,5900 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 INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1125 54272566 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
22 -Apr 2010
r
Signature
218.55 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund