220355 05/21/2013 „a CITY OF CARMEL, INDIANA VENDOR: 295900 Page 1 of 1
ONE CIVIC SQUARE ST VINCENT HOSPITAL CHECK AMOUNT: $218.55
CARMEL, INDIANA 46032 EAP
say° 8401 HARCOURT ROAD CHECK NUMBER: 220355
INDIANAPOLIS IN 46260
CHECK DATE: 5/21/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4340700 58748049 218 . 55 MEDICAL FEES
St. Vincent Stress Centers
ST. VINCENT STRESS CENTER Amount Due: $218.55
ST. VINCENT EAP Amount Paid: 21s SS
8401 Harcourt Road
INDIANAPOLIS, IN 46260
A/R Account# 3-1000-1130-00
Date Account Number
4/12/13 5-20386066
Invoice#058748049
Carmel Clay Parks & Recreation
Attn: Lynn Russell
1411 E. 116th Street
Carmel, IN 46032
-- To ensure proper credit to your account, please enclose top portion of this invoice with your payment.- ---- -- —�
ljp� 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
2013
May EAP Services 1 $72.85
2013
June EAP Services 1 $72.85
2013
Purchase EA -� ..-, ',
De3rriptlon_ �,_I�a�.�, -��3 APR 18 2013
P.O.# PorF
Budopt
1_ine bescr
Purchaser Date ►3 Total $218.55
Approval D;+ta
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
4/12/13 58748049 Employee Assistance Program Apr-Jun'13 $ 218 55
I
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 58748049 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
16-May 2013
Signature
$ 218.55 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund