226342 11/19/2013 CITY OF CARMEL, INDIANA VENDOR: 00352957 Page 1 of 1
ONE CIVIC SQUARE HOPE HEALTH CHECK AMOUNT: $1,656.36
CARMEL, INDIANA 46032 350 E.MICHIGAN AVENUE,SUITE 225
KALAMAZOO MI 49007-3853 CHECK NUMBER: 226342
CHECK DATE: 11/19/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1201 R4341980 26421 525330 1, 656 . 36 WELLNESS PROGRAM
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D Dine;:;;!;; < `< 11/20/2013
4;� INVOICE
rnun ;:Duc:;::;; 1,656.36
Exclusive Distributor--IHAC, IN C,
e 350 East Michigan Avenue j�j T` 1 :'< » 525330
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HEAj� 1 2 13 I> 166655
Kalamazoo, MI 49007-3851 `�O r
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Iriotce; ate; ;; 10/31/2013
Page: 1
Remit payment to:
Hope Health/IHAC
Sold TO: 350 East Michigan Ave., Ste. 225
Barbara Lamb Kalamazoo, MI 49007-3853
Director of Human Resources For faster processing call 800-334-4094 or
City of Carmel fax to 269-343-6260
One Civic Square a a re t ar eat t .:out a uv
Carmel IN 46032 Card # Exp.Date
Signature Amt.Paid
*** PLEASE SEND THIS PORTION WITH YOUR PAYMENT***
--- -- _— - _--- _ RFTA IN:TU7c_PORT?nN-FOR YniiR.RECORDS-- --.-----
Exclusive Distributor--IHAC, INC
350 East Michigan Avenue
HEAT T�3 Suite 225 C11ent No. .. invoice. o P Q1urier
Now that's amazing! Kalamazoo, MI 49007-3851 166655 525330
rirn»»>:: t>41in Uf.1VI rI<c :..:: r..tom e1 au€nt>
5 1 II E He 1 1 nd r 2 1
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1 Cover flap 69.000 69.00
1 Color thane 99.000 99.00 :!
UPS Ground & Handling 69.36
__ _ __ _
Invoice Subtotal 1,656.36
Tax Amount
Ship Barbara U b 1 656 36
Director of Hums Resources Invoice TOtal
To: . City of Carmel
One Civic Square
HWE
Carmel IN 46032
Thank you for your order! Please call 800-334-4094 if you have any 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 I 525330 I 43-419.80 I $1,656.36 1 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, November 18, 2013
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))
11/20/13 525330 $1,656.36
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