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160080 05/28/2008 CITY OF CARMEL, INDIANA VENDOR: 354957 Page 1 of 1 ONE CIVIC SQUARE SPECTRUM HEALTH SYSTEMS CHECK AMOUNT: $191.60 s, CARMEL, INDIANA 46032 3535 E 96TH ST SUITE 114 INDIANAPOLIS IN 46240 CHECK NUMBER: 160080 CHECK DATE: 5/28/2008 l? ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRI 1201 R4341980 16622 2448 19.1.60 WELLNESS PLAN Spectrum Health Systems Invoice 3535 East 96th Street Suite 114 Date Invoice Indianapolis, IN 46240 5/19/2008 2448 Bill To City of Carmel Barbara Lamb One Civic Square Cannel, IN 46032 P.C. No. Terms Project Upon Receipt Quantity Description Rate Amount 86 Stretch Bands Incentive for Stretch Band Challenge 1.60 137.60 2 VISA Gift Cards 27.00 54.00 Please call Sarah if you have any questions regarding this invoice. Thank you! Total $191.60 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 Spectrum Health Systems Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) --Visa Gift Cards 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. 05123106 ALLOWED 20 S pectrum Health Systems IN SUM OF 3535 East 96th Street, Suite 114 Indianapolis, IN 46240 $191.60 ON ACCOUNT OF APPROPRIATION FOR GENERALFUND 1201 Human Resources Board Members Po# or INVOICE NO. ACCT #/TITLE AMOUNT DEPT- I hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and that the partial 2448 41980 60 materials or services itemized thereon for which charge is made were ordered and received except 20 r Signet re Cost distribution ledger classification if Title claim paid motor vehicle highway fund