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HomeMy WebLinkAbout203171 10/25/2011 CITY OF CARMEL, INDIANA VENDOR: 360209 Page 1 of 1 ONE CIVIC SQUARE ST VINCENTS EMPLOYEE ASSISTANCEACK AMOUNT: $2,845.50 CARMEL INDIANA 46032 8401 HARCOURT ROAD INDIANAPOLIS IN 46260 CHECK NUMBER: 203171 CHECK DATE: 1012512011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1205 4347500 10.11.11 2,845.50 GENERAL INSURANCE Rate: 1.75 Number of Employees: 542 ACCT 5- 20376299 PATIENT: *CITY OF CARMEL. CHG AMT PAY /ADJ BALANCE INVOICE 055587075 EMP PROVIDER 04/13/11 APRIL 2011 948.50 04/13/11 MAY 2011 948.50 04/13/11 JUNE 2011 948.50 05/31/11 COMPANY PAYMENT 2845.50 06/30/11 COMPANY PAYMENT 2845.50 07/14/11 COMPANY PAYMENT 2845.50 INVOICE BALANCE: 0.00 INVOICE 055915066 EMP PROVIDER 07/12/11 JULY 2011 948.50 07/12/11 AUGUST 2011 948.50 07/12/11 SEPTEMBER 2011 948.50 07/14/11 COMPANY PAYMENT 2845.50 INVOICE BALANCE: 0.00 INVOICE 056238074 EMP PROVIDER 10 /10 /11 OCTOBER 2011 Q 948.50 10/10/11 NOVEMBER 2011 D 948.50 10/10/11 DECEMBER 2011 OCT 2 4 2011 948.50 INVOICE BALANCE: 2845.50 By Account 0 -30 days 31 -60 days 61 -90 days >90 days Balance 5- 20376299 2845.50 0.00 0.00 0.00 2845.50 PAGE: 1 ST VINCENT EMPL. ASST. M F 9a.m. to 4p.m. 8401 HARCOURT RD Ph: 317 -338 -4900 INDIANAPOLIS IN 46260 VOUCHER NO. WARRANT NO. ALLOWED 20 St. Vincent Employee Assistance Program I '-IN SUM OF 8401 Harcourt Rd Indianapolis, IN 46260 $2,845.50 ON ACCOUNT OF APPROPRIATION FOR Administration Department PO# 1 Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members 1205 10.11.11 43- 475.00 $2,845.50 I hereby certify that the attached invoice(s), or 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 Monday, October 24, 2011 Director, Administration Title Cost distribution ledger classification if claim paid motor vehicle highway fund 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 Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 10111/11 1011.11 $2,845.50 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