HomeMy WebLinkAbout241827 02/03/15 `%� ��p''F CITY OF CARMEL, INDIANA VENDOR: 00350364
® sj ONE CIVIC SQUARE PUBLIC SAFETY MEDICAL SERVICES CHECK AMOUNT: $.....***87.4
?Q CARMEL, INDIANA 46032 324 E NEW YORK ST SUITE 300 CHECK NUMBER: 241827
49Mi�oN. INDIANAPOLIS IN 46204 CHECK DATE: 02/03/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1091 4340700 24791 87.46 MEDICAL FEES
Public Safety Medical - INVOICE
o Public Safety Medical Invoice Date: 01/14/2015
. 324 E. New York Street Invoice# 00-24791
Suite 300 Terms:
..
Indianapolis,� P , IN 46204
7JAN 16 2015
BY:
0
Carmel Clay Parks& Recreation/CARMELPARK
F- Attn: Jeff Kramer
m- 1411 E. 116th Street
Carmel, IN 46032
Exclusivey g u lc afety Professionals Since 1990.
:Date Employee Description Amount Balance Due
01 09115 Wri ht Paula A. He atitis B Vacc-Booster $76.52 1 $76.52
Injection Fee $10.94 1 $10.94
Total Charges->. $87.46 .
Total Payments&Balance Due-> $0.00 $87.46
Please write invoice number on payment check. Our Federal Employer identification number is 35-2079797.
We greatly appreciate the opportunity to serve you. If you have any questions regarding this invoice, please contact
Debbie Pieper at 317-964-2330.
Purchase
Descrip*ion 'HC—,/-
P.O.# PorF
G.L.# IoQ ) - Lj5go700
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Line 'ascr ES
Purchase Date
Approv I Date 12,0is-
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.
00350364 Public Safety Medical Services Terms
324 E. New York Street, Ste 300
Indianapolis, IN 46204
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
1/14/15 24791 Hep B Vaccine $ 87.46
Total $ 87.46
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
120
Clerk-Treasurer
i
Voucher No. Warrant No.
00350364 Public Safety Medical Services Allowed 20
324 E. New York Street, Ste 300
Indianapolis, IN 46204
In Sum of$
$ 87.46
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
i
I
PO#or Board Members
INVOICE NO. ACCT#/TITLE AMOUNT
Dept'#
1091 24791 4340700 $ 87.46 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
January 29, 2015
i
Signature
$ 87.46 Accounts Payable Coordinator
Cost distribution ledger classification if I Title
claim paid motor vehicle highway fund
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