HomeMy WebLinkAbout162499 08/07/2008 CITY OF CARMEL, INDIANA VENDOR: 354957 Page 1 of 1
ONE CIVIC SQUARE SPECTRUM HEALTH SYSTEMS
CARMEL, INDIANA 46032 3535 E 96TH ST SUITE 114 CHECK AMOUNT: $14,689.00
INDIANAPOLIS IN 46240
CHECK NUMBER: 162499
CHECK DATE: 8/7/2008
DEP ARTMEN T ACCO PO NU INVOICE NUMBER AM OUNT DESCRIPTION
1201 R4341980 16622 2496 14,689.00 WELLNESS PLAN
Spectrum Health Systems Invoice
3535 East 96th Street Suite 114 Date Invoice
Indianapolis, IN 46240
7/23/2008 2496
Bill To
City of Carmel
Barbara Lamb
One Civic Square
Carmel, IN 46032
P.O. No. Terms Project
Upon Receipt
Quantity Description Rate Amount
I Express Health Program 2008 14,689.00 14,689.00
1st of 3 invoices: 3rd invoice will be adjusted to reflect actual employee participation as
outlined in the proposal
We appreciate our partnership.
Total $14,689.00
Prescribeci~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
Spectrum Health Systems Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
Total i14 6 89_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.
20
Clerk- Treasurer
VOUCHER NO WARRANT NO.
ALLOWED 20
Spectrum He alth Systems
IN SUM OF
3535 East 96th Street, Suite 114
incHanapolis, IN 46240
$14,689.00
ON ACCOUNT OF APPROPRIATION FOR
GENERALFUND
1201 Human Resources
Board Members
PO# or DEPT #i INVOICE NO. ACCT #/TITLE AMOUNT I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
partial 2496 419-80 0o materials or services itemized thereon for
which charge is made were ordered and
received except
20
1 -,Si aoture
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund