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189006 08/18/2010 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: 189006 INDIANAPOLIS IN 46260 CHECK DATE: 8/18/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1125 4340700 54589525 218.55 MEDICAL FEES W St. Vincent Stress Centers ST. VINCENT STRESS CENTER Amount Due: $218.55 ST. VINCENT EAP Amount Paid: 8401 Harcourt Road INDIANAPOLIS, IN 46260 A/R Account 3 -1000- 1130 -00 Date Account Number 7/21/10 5- 20386066 Invoice #054589525 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. St. Vincent Stress Centers A/R 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 July EAP Services 1 $72.85 2010 August EAP Services 1 $72.85 2010 September EAP Services 1 $72.85 2010 Purchase �f� Description T e P.O. P or F p T Bu 6 3 a Budget Line Descr JUL Z' 8. 201 Purah !O ApproY Date______ Total $218.55 For questions regarding this bill please call (317) 338 -4900. To ensure proper credit to your account, please enclose top portion of this invoice with your payment. v# 0 5 ZI SS qg �CNr iYx t 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 July EAP Services 1 $72.85 2010 August EAP Services 1 2010 $72.85 Sept September Sept EAP Services Purchase Description P.O. Pot f G.L. Bud g et e� Line Decor JUL 2 8 20 1 0 Purch IO Approv Date B7. Total $218.55 For questions regarding this bill please call (317) 338 -4900. 00�IAAL� 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 7/21110 54589525 Employee Assistance Program Jul -Se '10 218.55 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 .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 INVOICE NO. ACCT#TTITLE AMOUNT Board Members Dept 1125 54589525 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 12-Aug 2010 Ak,bM9MM 11 Signature 218.55 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund