193131 12/22/2010 CITY OF CARMEL, INDIANA VENDOR: 00350402 Page 1 of 1
0 ONE CIVIC SQUARE INDIANA CHAMBER OF COMMERCE
CARMEL, INDIANA 46032 PO BOX 44926 CHECK AMOUNT: $198.00
INDIANAPOLIS IN 46244 CHECK NUMBER: 193131
CHECK DATE: 12/22/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1201 4357004 0000118434 198.00 EXTERNAL INSTRUCT FEE
?J Indiana Page: 1 of I
Z_
Indiana Chamber oi'C'ommerce
1 The Voice of I IS W Washington St, 4tc 850 S. Indianapolis. IN, 46 t S;%
Indiana Rusinegn' Pltonc: (317)264 -.31 ill tax: (317)264 -6955
PAST DUE INVOICE
Date: 13 -Dec -2010
Bill -To: 000000090786 -0 Order Number 5000575137
Order Date: 22- Sep -2010
Invoice Number 0000118434
Nis. Barbara Lamb
Human Resources Director
City of Carmel
I Civic Sq
Cannel, IN 46032 -2584
Unit
Product FulfillSlatus Status Qty Unit Price Discount Coupon Adjustment Total
HCOCTl0- Health Care Reform Active Active 1 229.00 130.00 0.00 0.00 99.00
HCOCTIO- Health Care Reform Active Active 1 229,00 130.00 0.00 0,00 99.00
Shipping: 0.00
Total 198.00
Paid To Date 0.00
Current Amount Due 198.00
nD
L _:1 10 2010
By
Please detach the lower portion and return it with your payment. Thank you.
Customer 000000090786 -0 Ms. Barbara Lamb
Order No 5000575137 Invoice No: 0000118434 Balance Due(USD): 198.00
Credit Card Exp. Date: Amount
Credit Cards Accepted (AE, MS, VS, AE2, MS2, VS2, AL3, VS3, MS3)
Send payments to Indiana Chamber of Commerce
115 W Washington St
Ste 850 S
Indianapolis, IN 46204
VOUCHER NO. WARRANT NO.
ALLOWED 20
Indiana Chamber of Commerece
IN SUM OF
115 W. Washington St., Suite 850 S.
Indianapolis, IN 46204
$198.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel HR Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1201 I 0000118434 I 43- 570.04 I $198.00 1 hereby certify that the attached invoice(s), or
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
Monday, December 20, 2010
Director, HR
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
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.
Payee
Purchase Order No,
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
09/22/10 0000118434 $198.00
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