HomeMy WebLinkAbout163781 09/17/2008 CITY OF CARMEL, INDIANA VENDOR: 00352957 Page 1 of 1
d.� ONE CIVIC SQUARE HOPE HEALTH CHECK AMOUNT: $1,764.25
)a CARMEL, INDIANA 46032 350 E. MICHIGAN AVENUE, SUITE 301
KALAMAZOO MI 49007 -9834 CHECK NUMBER: 163781
CHECK DATE: 9/17/2008
DEPARTMENT ACCOUNT PO NUMBER INVOIC NU MBER AMOUNT D ESCRIPTION
1201 4341980 406987 1,764.25 WELLNESS PROGRAM
I
i
INVOICE HP 406987
CLIENT 166655
.z; PAGE 1
HFAI TL Exclusive Distributor -IHAC, Inc. TAX ID 38-1784210
PLOYeCS DATE 8/18/2008
Total Invoice Charges due on or before September 7, 2008 $1,764,25
BILLED TO: CREDIT CARD PAYMENTS ON REVERSE
OR PLEASE MAKE CHECK PAYABLE TO:
Shelly Lingelbaugh
City of Carmel Ho e Health /IHAC
One Civic Square 35� East Michi an Suite 301
Carmel IN 46032 Kalamazoo, MI 9007 -3851
SEND THIS PORTION WITH YOUR PAYMENT
RETAIN THIS PORTION FOR YOUR RECORDS
�K INVOICE HP 406987
350 East Michigan Avenue, Suite 301
Kalamazoo, MI 49007 3851 CLIENT 166655
I 1- +V- E#, t (269) 343 -0770 DATE 8/18/2008
For: Shelly Lin elbaugh
Office Administrator
City of Carmel
One Civic Square
Carmel IN 46032
Quantity Item Description Unit Cost Total Cost
625 761 HOPE Health Calendar 2009 $2.580 Ea. 1,612.50
Cover flan 69.00
Shipping Handling 82.75
THANK YOU FOR YOUR ORDER! TOTAL INVOICE CHARGES $1,764.25
Please call 1 -800- 334 -4094 if you have any questions.
Please visit our Web site www.hopehealth.com
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VISA, MasterCard, Discover and American Express are accepted. For Michigan residents, 6 sales tax has been
added. If your orginazation is tax exempt in Michigan, please include your tax ID
For faster processing call 1- 800 -334 -4094, FAX to (269) 343 -6260, or fill out below and return.
I would like to charge to my credit card (check one):
❑0 TTI I I I I I I I I I F1
CREDIT CARD NUMBER MO YR.
Authorized Signature: EXPIRATION DATE
Client
Invoice
Prescrigap 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
rope Health Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
08/18108 40BA87 6 9 0 5z H
We Health Galendar 2009 r
Total
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.
0911 5lQ,8,
ALLOWED 20
H) ope Health
IN SUM OF
350 East Michigan, Suite 301
a amazon, MI 49007 -3851
$1,764.25
ON ACCOUNT OF APPROPRIATION FOR
GENERALFUND
1201 Human Resources
Board Members
p PT INVOICE NO. ACCT #!TITLE AMOUNT I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
1201 q 06987 41 q-8n 5 materials or services itemized thereon for
which charge is made were ordered and
received except
20
gnatur
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund