213955 10/23/2012 CITY OF CARMEL, INDIANA VENDOR: 00352957 Page 1 of 1
ONE CIVIC SQUARE HOPE HEALTH
CARMEL, INDIANA 46032 350 E.MICHIGAN AVENUE,SUITE 301 CHECK AMOUNT: $1,656.36
KALAMAZOO MI 49007-9834 CHECK NUMBER: 213955
CHECK DATE: 10/23/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1201 R4341980 26421 515985 1, 656 . 36 WELLNESS PROGRAM
Date Dine: 10/31/2012
.. ..
ITV®ICE noutit:Due 1,656.36
....... ....
Exclusive Distributor--IHAC, INC
NWE
® 350 East Michigan Avenue I11vo*We:'Nq :::.: 515985
Suite 225
HEAL TH .Client.No:' 166655
Now that's amazing! Kalamazoo, MI 49007-3851 -
Invoice Date:..:: : 10/11/2012
Page: 1
Remit payment to:
Hope Health/IHAC
Sold To: 350 East Michigan Ave., Ste. 225
Jim Spelbring Kalamazoo, MI 49007-3853
Human Resources For faster processing call 800-334-4094 or
City of Carmel fax to 269-343-6260.
One Civic Square If:Pavia :B Credit:Card Please fill out belokv:
Carmel IN 46032 Card # Exp.Date
Signature Amt.Paid
*** PLEASE SEND THIS PORTION--WITH YOUR PAYMENT -
RETA1_PrT
H9,.)Pei Exclusive Distributor--IHAC, INC
® 350 East Michigan Avenue
Suite 225 ;. ,
HFATTH 0ient'No ::. I> voice No P:O. Number
Now thats amazing! Kalamazoo,MI 49007-3851 166655 515985
uant>t >:::. t
tem:> :esc>rI iou:;>;. »: /M:: rice ;er:_.eIn'>'" et Amount:::...
550 81 HOPE Health.Calendar 2013 - Illo Ea. 1 2.580 1,419.00
1 Cover flap 69.000 69.00
1 Color change 99.000 99.00
UPS Ground & Handling 69.36
Li
B
Invoice Subtotal 1,656.36
Tax Amount .00
Ship airs spelbring 1 656.36
Human Resources Invoice Total
To: City of Carmel
One Civic Square
Carmel IN 46032
Thank you for your order! Please call 800-334-4094 if you have ally questions.
Be sure to see "What's New"at www.HopeHealth.com.
ONETMMST
VOUCHER NO. WARRANT NO.
ALLOWED 20
Hope Health / IHAC
IN SUM OF $
350 East Michigan Ave., Ste. 225
Kalamazoo, MI 49007-3853
$1,656.36
ON ACCOUNT OF APPROPRIATION FOR
Carmel HR Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
26421 515985 43-419.80 $1,656.36 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 22, 2012
Director, HR
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))
10/11/12 515985 Calendars $1,656.36
I 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