HomeMy WebLinkAbout238470 10/21/14 CITY OF CARMEL, INDIANA VENDOR: 236175
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® ONE CIVIC SQUARE PARKSIDE ANIMAL HOSPITAL CHECK AMOUNT: $ ...-269.19*
,. =4 CARMEL, INDIANA 46032 12962 PUBLISHERS DRIVE CHECK NUMBER: 238470
FISHERS IN 46038 CHECK DATE: 10/21/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4357600 32433 221007 269.19 SPAY SURGERY
PARKSIDE ANIMAL HOSPITAL 10/01/2014
1:25 PM
12962 Publishers Drive Invoice 221007
Fishers, IN 46038
(317)849-1440
Acc.No: 322
Phone: (317)571-2500
Phone 2: (317)571-2512
Patient: LOENA DOB: 2/10/2012
Police De Carmel Species: Canine Age: 2 yr 7 mo
Carrmel
3 mel Square, IN 46032 Breed: Belgian Malinois Sex: FEMALE SPAYED
Color: Brown Tag:
Weight: 55.70 Ib
Client: Police De Carmel
LOENA
Species: Canine Breed: Belgian 14lalmois „ Weight: 55.70 lb
Provider Service/Item Date Qty Price Amount
Craig Johnson, D.V.M. Exam-Courtesy 09/29/2014 1.00 $0.00 $0.00
Craig Johnson, D.V.M. Preanesthetic Panel 0-4 years 09/29/2014 1.00 $43.54 $43.54
Line Discount:$10.89
Craig Johnson,D.V.M. Anesthetic Administration 09/29/2014 1.00 $0.00 $0.00
Craig Johnson,D.V.M. Propoflo Anesthetic Induction 09/29/2014 1.00 $29.71 $29.71
Line Discount:$7.43
Craig Johnson,D.V.M. Surgical Monitoring 09/29/2014 1.00 $0.00 $0.00
Craig Johnson, D.V.M. Surgery Pack Fee 09/29/2014 1.00 $12.23 $12.23
Line Discount:$3.06
Craig Johnson,D.V.M. Ovariohysterectomy-Ca 50-1001b 09/29/2014 1.00 $233.47 $233.47
Line Discount: $81.71
Craig Johnson,D.V.M. Flocillin Injectable 09/29/2014 1.00 $27.33 $27.33
Line Discount:$6.83
Craig Johnson,D.V.M. Rimadyl Injection 09/29/2014 1.00 $19.24 $19.24
Line Discount:$4.81
Craig Johnson,D.V.M. Biological Waste Hazard fee 09/29/2014 1.00 $3.00 $3.00
Line Discount:$0.75
Craig Johnson, D.V.M. Rimadyl 100MG Caplets 09/29/2014 4.00 $21.54
Line Discount: $5.39
Tax $0.00
Discount $120.87
Net Invoice $269.19
Previous Balance $0.00
Payment $0.00
Net Balance Due $269.19
Reminders for LOENA Heartworm-fest Occult 05/29/2015
Exam-Annual Wellness/Vaccine 05/29/2015
Bordetella.\/ace Annual 05/29/2015
Heartgard Plus 51-1009 12 mos. 05/29/2015
Fecal Exam Annual 05/29/2015
INDIANA RETAIL TAX EXEMPT PAGE
City ®f C°�rmel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
////lei
FEDERAL EXCISE TAX EXEMPT
35-60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,A/P
CARMEL, INDIANA 46032-2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL- 1997 SHIPPING LABELS AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
18M 2OU
Patslde Animml Hospital Carmel Police Depaftmont
VENDOR
SHIP 3 CIVIC aqum
12282 Publlshora®rIea TO Cwmol, IN 4M
Fishers, IN 4 (399)571-M'2
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNITOF_MEASURE _ .� ___ __ _ - .hFRCRIPTInN_ - __ .-_-- _... _.._ �___.___
x� _
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VOUCHERVVARRANTNO`_____
ALLOWED 20___
|NTHE SUM OF$
ONACCOUNT OFAPPROPRIATION FOR
Board Members
PO#or INVOICE NO. ACCT#/TITLE AMOUNT
DEPT# ( hereby certify that the attached invoiue(s). or
bill(s) is (are) true and correct and that the
materials orservices itemized thereon for
which charge iomade were ordered and
received except ...
2"-___
` .
... -____-__'—_--___- --_-_
` Signature
'
Title
Cost d istribution 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))
10/01/14 221007 K9 Lo Lo Spay surgery $269.19
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
Parkside Animal Hospital
IN SUM OF $
12962 Publishers Drive
Fishers, IN 46038
$269.19
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
F32433 I 221007 I 43-576.00 I $269.19 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
Friday, October 17, 2014
4L, Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund