HomeMy WebLinkAbout206816 02/28/2012 CITY OF CARMEL, INDIANA VENDOR: 295900 Page 1 of 1
ONE CIVIC SQUARE ST VINCENT HOSPITAL
CARMEL, INDIANA 46032 EAP CHECK AMOUNT: $216.55
8401 HARCOURT ROAD CHECK NUMBER: 206816
INDIANAPOLIS IN 46260
CHECK DATE: 2/28/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4340700 55915043 218.55 MEDICAL FEES
St. Vincent Stress Centers
ST. VINCENT STRESS CENTER Amount Due: $218.55
ST. VINCENT EAP Amount Paid:
8401 Harcourt Road
INDIANAPOLIS, IN 46260
A/R Account 3- 1000 1130 -00
Date Account Number
07/14/11 5- 20386066
Invoice #055915043
Carmel Clay Parks Recreation
Attn: Lynn Russell+
1411 E. 116" Street
Carmel, IN 46032 F ��12
e
To ensure proper credit to your account, please enclose top portion of this invoice with your p `rHri rit-"
J W St. Vincent Stress Centers A/R Account 3 -1000- 1130 -00
Rate No. of Employees
ST. VINCENT STRESS CENTER $2.35 31
ST. VINCENT EAP
8401 Harcourt Road
INDIANAPOLIS, IN 46260
Date Description Units Amount
July EAP Services 1 $72.85
2011
August EAP Services 1 $72.85
2011
September EAP Services 1 $72.85
2011
Purchase
Description 5V tC� J U L SE 11
P.O.# PorF
G.L.
Line t
Line escr
Purchaser Date
Approval Date Total $218.55
For questions regarding this bill please call (317) 338 -4900.
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of 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.
295900 St. Vincent Stress Center Terms
8401 Harcourt Road Date Due
Indianapolis IN 46260
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
7114111 55915043 Employee Assistance Program Jul,Aug,Sep'11 218.55
Total 218.55
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.
295900 St. Vincent Stress Center Allowed 20
8401 Harcourt Road
Indianapolis IN 46260
In Sum of
218.55
ON ACCOUNT OF APPROPRIATION FOR
101 -General Fund
PO# or INVOICE NO. ACCT /TITLE AMOUNT Board Members
Dept
1125 55915043 4340700 218.55
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
23 -Feb 2012
Signature
218.55 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund