Payment Request
PAYEE | LIFE INSURANCE COMPANY OF NORTH AMERICA |
---|---|
EXPENSE CATEGORY | SHORT-TERM DISABILITY PREMIUMS |
DEPARTMENT | HUMAN RESOURCES |
FUND | EMPLOYEE BENEFITS FUND |
PROGRAM | FULLY FUNDED BY CITY - EMPLOYEE/RETIREE |
ACTIVITY | FULLY FUNDED BY CITY - EMPLOYEE/RETIREE | PAYMENT REQUEST | PRM 5800 21101801604 |
PURCHASE ORDER | CONTRACT | DESCRIPTION | REF. LINE | CHECK DATE | CHECK STATUS | AMOUNT |
---|---|---|---|---|---|---|
DO 5800 21101301028 | n/a | Disability Insurance | 111 | 10/19/2021 | Paid | $51,270.44 |