156329 02/06/2008 CITY OF CARMEL, INDIANA VENDOR: 295900 Page 1 of 1
ONE CIVIC SQUARE ST VINCENT HOSPITAL
RR CARMEL, INDIANA 46032 EAP CHECK AMOUNT: $3,179.85
8401 HARCOURT ROAD CHECK NUMBER: 156329
INDIANAPOLIS IN 46260
CHECK DATE: 2/612008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUM BER AMOUNT DESCRIPTION
1205 R4347500 16049 051962882 3,179.85 EAP SERVICE
II
ST VINCENT EMPL. ASST. PROGRAM
8401 HARCOURT RD
INDIANAPOLIS IN 46260 Date Account Number Balance
01/16/08 5- 20376299 3179.85
J-CITY OF CARMEL
LAMB,BARB
CITY HALL 1 CIVIC SQUARE
CARMEL,IN 46032
0 1 °ase enclose top por -ion 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
INVOICE BALANCE: 3179.85
w
Account 0 -30 days 31 -60 days 61 -90 days >90 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 ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
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 Employee Assistant Program Purchase Order No.
Terms
r�
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
0 r-tuary— Febt•uary— Miarch 288
Total X 9.85
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
VOUCHER 1V0 02104M ARRANT NO.
ALLOWED 20
St Vincent Employee Assistant Program
IN SUM OF
9401 Harcourt Road
$3,179.85
ON ACCOUNT OF APPROPRIATION FOR
GENERALFUND
1205 Administration
Board Members
P0# or
DEPT. INVOICE NO. ACCT #/TITLE AMOUNT I hereby certify that the attached invoice(s), or
96049 bill(s) is (are) true and correct and that the
partial 051962882 475 $3 materials or services itemized thereon for
which charge is made were ordered and
received except
20
Sin ure
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund