HomeMy WebLinkAbout162054 07/23/2008 CITY OF CARMEL, INDIANA VENDOR: 295900 Page 1 of 1
ONE CIVIC SQUARE ST VINCENT HOSPITAL
CARMEL, INDIANA 46032 EAP CHECK AMOUNT: $3,179.85
8401 HARCOURT ROAD CHECK NUMBER: 162054
INDIANAPOLIS IN 46260
CHECK DATE: 7123/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1201 R4341980 16622 052393402 3,179.85 WELLNESS PLAN
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ST VINCENT EMPL. ASST. PROGRAM
8401 HARCOURT RD 6�
INDIANAPOLIS IN 46260 Date Account Number Balance.
O 07/10/08 5- 20376299 3179.85
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*CITY OF CARMEL
LAMB,BARB
CITY HALL 1 CIVIC SQUARE
CARMEL,IN 46032
Please enclose top portion with payment
Rate: 2.15 Number of Employees: 493
ACCT 5-- 20376299 PATIENT: *CITY OF CARMEL CHG AMT PAY /ADJ BALANCE
INVOICE 051962882
EMP PROVIDER
01/01/08 JANUARY 2008 1059.95
01/01/08 FEBRUARY 2008 1059.95
01/01/08 MARCH 2008 1059.95
02/25/08 COMPANY PAYMENT 3179.85
03/26/08 COMPANY PAYMENT 3179.85
04/14/08 COMPANY PAYMENT 3179.85
INVOICE BALANCE: 0.00
INVOICE 052172434
EMP PROVIDER
04/07/08 APRIL 2008 1059.95
04/07/08 MAY 2008 1059.95
04/07/08 JUNE 2008 1059.95
04/14/08 COMPANY PAYMENT 3179.85
INVOICE BALANCE: 0.00
INVOICE 052393402
EMP PROVIDER
07/08/08 JULY 2008 1.059.95
07/08/08 AUGUST 2008 1059.95
07/08/08 SEPTEMBER 2008 1059.95
INVOICE BALANCE: 3179.85
Account 0 -30 days 31 -60 days 61 -90 days X90 days Balance Due
5- 20376299 3179.85 0.00 0.00 0.00 3179.85
PAGE: 1
ST VINCENT EMPL. ASST. M F 9a.m. to 4p.m.
8401 HARCOURT RD Ph: 317- 338 -4900
INDIANAPOLIS IN 46260
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
St. Vincent Empl Asst Program Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
September 2008
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.
071211
ALLOWED 20_
St. Vincent Empl Asst Program
IN SUM OF
8401 Harcourt Road
Indianapolis, 46260
$3,179.85
ON ACCOUNT OF APPROPRIATION FOR
GENERAL FUND
1201 Human Resources
Board Members
PO# or DEPT. INVOICE NO. ACCT #/TITLE AMOUNT I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
p artial 052393402 Al q-RC) 8 .5materials or services itemized thereon for
which charge is made were ordered and
received except
20
r
�sign re
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund