246517 06/17/15 �� ��`''° CITY OF CARMEL, INDIANA VENDOR: 369480
J® ONE CIVIC SQUARE ROBERT BLANKENSHIP, MD CHECK AMOUNT: 24.5R'2,400.00*
:� ,�; CARMEL, INDIANA 46032 12555 SPRING VIOLET PLACE CHECK NUMBER: 246517
M��TON�°� CARMEL IN 46033 CHECK DATE: 06/17/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4357003 EXAMS 2,400.00 INTERNAL TRAINING FEE
INVOICE
Date: 4/15/2015—Q1-2015
Name of Company: Robert Blankenship, M.D.
Address/Zip: 12555 Spring Violet Place
Carmel, IN 46033
Telephone: 317-645-8850
Project Name: EMS Medical Instruction
Services Provided:
Preparation and delivery of Point-of-Care Ultrasound Lectures
Date Hours Rate
March 24 $100 per hour
GRAND TOTAL: $2,400.00
Robert Blankenship, M.D.
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VOUCHER NO. WARRANT NO.
ALLOWED 20
Robert Blankenship, M.D.
IN SUM OF$
i
12555 Spring Violet Place ;
Carmel, IN 46033
$2,400.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1120 43-570.01 $2,400.00 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
JUN I :J 20115
woo
Fire Chiefj
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))
$2,400.00
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