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