159614 05/14/2008 CITY OF CARMEL, INDIANA VENDOR: 295900 Page 1 of 1
ONE CIVIC SQUARE ST VINCENT HOSPITAL
(9 CARMEL, INDIANA 46032 EAP CHECK AMOUNT: $218.55
8401 HARCOURT ROAD CHECK NUMBER: 159614
INDIANAPOLIS IN 46260
CHECK DATE: 5/14/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4122100 52172429 218.55 DISABILITY INSURANCE
f
ST VI ]\JiCENT EMPL ASST. PROGRAM
8401 HARCOURT RD
INDIANAPOLIS IN 46260 Date Account Number Balance
04/14/08 5- 20386066 218.55
4. i I V ED
D
�F.
*CARMEL CLAY PARKS RECREATI
APR 2008
1 E 116TH STREET
CARMEL,IN 46032 =y
Please enclose top portion with payment
Rate: 2.35 Number of Employees: 31
ACCT 5- 20386066 PATIENT: *CARMEL CLAY PARKS CHG AMT PAY /ADJ BALANCE
INVOICE 052172429
EMP PROVIDER
04/07/08 APRIL 2008 72.85
04/07/08 MAY 2008 72.85
04/07/08 JUNE 2008 72.85
INVOICE BALANCE: 218.55
a. A41 �aaio6
Account 0 -30 days 31 -60 days 61 -90 days X90 days Balance Due
5- 20386066 218.55 0.00 0.00 0.00 218.55
PAGE: I
ST VINCENT EMPL. ASST. M F 9a.m. to 4p.m.
8401 HARCOURT RD Ph: 317- 338 -4900
INDIANAPOLIS IN 46260
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.
St. Vincent Empl. Asst. Program Terms
8401 Harcourt Road Date Due
Indianapolis IN 46260
Invoice Invoice Description
Date Number
or note attached invoice(s) or bill(s)) Amount
218.55
4114!08 52172429 2nd Quarter Charges
Total L 218.55
I 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
J
F
Voucher No. Warrant No.
St. Vincent Empl. Asst. Program 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 52172429 4122100 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 -May 2008
Sign re
218.55 Business Services Manager
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
i