176941 09/02/2009 CITY OF CARMEL, INDIANA VENDOR: 360209 Page 1 of 1
ONE CIVIC SQUARE ST VINCENT STRESS CENTER
CARMEL, INDIANA 46032 8401 HARCOURT ROAD CHECK AMOUNT: $21855
INDIANAPOLIS IN 46260 CHECK NUMBER: 176941
CHECK DATE: 9/2/2009
DEPA ACCOUNT PO NUMBER INV OICE NU MBER AMOUNT DESCRIPTION
1125 4340700 53126127 218.55 MEDICAL FEES
r-�
W 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
4/8/09 5- 20386066
Invoice #053126127
Carmel Clay Parks Recreation
Attn: Lynn Russell
1411 E. 116 Street AUG 2
Carmel, IN 46032
T o ensure proper credit to your account, please_ endose_top_ portion_of -this- invoice- %ttith. yet- ir- payme ^t
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
April EAP Services 1 $72.85
2009
May EAP Services 1 $72.85
2009
June EAP Services 1 $72.85
2009
Purchase hpY n��'/ JUn,�
Description t 4 6 1
P.O. M P or F
G.L. 40 Do
Budge
in t �Vlicd I CGt_ F&5
Le escr
Purchaser
Approvai 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
r 8401 Harcourt Road Date Due
Indianapolis IN 46260
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
4/8/09 53126127 Employee Assistance Program Apr,May,Jun'09 218.55
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
L Indianapolis IN 46260
In Sum of
C
218.55
ON ACCOUNT OF APPROPRIATION FOR
101 -General Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1125 53126127 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
27 -Aug 2009
RM'1/YJ) 0I
Signature
218.55 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund