HomeMy WebLinkAbout214085 10/23/2012 CITY OF CARMEL, INDIANA VENDOR: 295900 Page 1 of 1
ONE CIVIC SQUARE T VINCENT HOSPITAL
CARMEL, INDIANA 46032 SP CHECK AMOUNT: $218.55
8401 HARCOURT ROAD CHECK NUMBER: 214085
INDIANAPOLIS IN 46260
CHECK DATE: 10/23/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4340700 57852011 218 . 55 MEDICAL FEES
St. Vincent Stress Centers
ST. VINCENT STRESS CENTER Amount Due: $218.55
ST. VINCENT EAP Amount Paid: 13.515
8401 Harcourt Road
INDIANAPOLIS, IN 46260
A/R Account# 3-1000-1130-00
Date Account Number
10/12/12 5-20386066
Invoice#057852011
Carmel Clay Parks & Recreation
Attn: Lynn Russell
1411 E. 116t1' Street
Carmel, IN 46032
To ensure proper credit to your account, please enclose top portion of this invoice with your payment.
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
October EAP Services 1 $72.85
2012
November EAP Services 1 $72.85
2012
December EAP Services 1 $72.85
2012
Purchase E n P �rVI Cc- 6C _DEG 12
Description
P.O.# P or F =----
G.L.# I1a5- 1-aBudget J'y)n�L �_ X22 5 Line Descr� � "`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
10/12/12 57852011 Employee Assistance Program Oct-Dec'12 $ 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 57852011 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
18-Oct 2012
��.h�01�rno
Signature
$ 218.55 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund