HomeMy WebLinkAbout229635 2/25/2014 "yf CITY OF CARMEL, INDIANA VENDOR: 00350364 Page 1 of 1
ONE CIVIC SQUARE PUBLIC SAFETY MEDICAL SERVICES CHECK AMOUNT: $187.53
i•�,io CARMEL, INDIANA 46032 324 E NEW YORK ST SUITE 300
INDIANAPOLIS IN 46204 CHECK NUMBER: 229635
CHECK DATE: 2/25/2014
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4341999 22279 187 . 53 OTHER PROFESSIONAL FE
INVOICE
0 Public Safety Medical Services
324 E. New York Street
E Suite 300
a Indianapolis, IN 46204
o Carmel Police Department/CARMEPD
E— Terms
3 Civic Square
Carmel, IN 46032 Invoice Date 02/06/2014
m Invoice# 00-22279
Date Employee Description Amount Balance Due
01/27/14 Stein Amy J. Fitness For DutV Exam Initial Level 2 $187.53 $187.53
Total Charges-> $187.53
Total Payments&Balance Due > $0.00 $187.53
Please write invoice number on payment check.
Our Federal Employer Identification Number is 35-2079797
BALANCE DUE
IN 15 DAYS
THANK YOU!!
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))
02/06/14 22279 fit for duty psych-Stein $187.53
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.
ALLOWED 20
Public Safety Medical Services
IN SUM OF $
324 E. New York Street, Suite 300
Indianapolis, IN 46204
$187.53
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1110 I 22279 I 43-419.99 ( $187.53 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
Thursday, February 20, 2014
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund