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HomeMy WebLinkAbout251225 11/04/15 Cqq
CITY OF CARMEL, INDIANA VENDOR: 00350364
® 41 ONE CIVIC SQUARE PUBLIC SAFETY MEDICAL SERVICES CHECK AMOUNT: $********38.83*
CARMEL, INDIANA 46032 324 E NEW YORK ST SUITE 300 CHECK NUMBER: 251225
INDIANAPOLIS IN 46204 CHECK DATE: 11/04/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1091 4340700 26512 38.83 MEDICAL FEES
PublSafety Medical - INVOICE
o Public Safety Medical Invoice Date: 09/02/2015 -. ?
.. 324 E. New York Street
Invoice# 00-26512
E Suite 300 Terms:
Ir Indianapolis, IN 46204 ~
FSREEEP 0 8 2015
c . Carmel Clay Parks&Recreation/CARMELPARK
Attn: Jeff Kramer
m . 1411 E. 116th Street
Carmel, IN 46032
Exclusively Serving Public Safety Professionals Since 9990.
Date - Employee Description: Amount Balance Due
08/27115 Wri ht Paula A. Veni uncture $0.00 $0.0o
Hep B Titer SAb-Quantitative Blood $38.83 $38.83
Total
,., Charges:- °: : $38.83
Total Payments Balance Due->- $0:00. $38.83
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.
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
9/2/15 26512 Medical Fees $ 38.83
Total Is 38.83
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.
00350364 Public Safety Medical Services Allowed 20
324 E. New York Street, Ste 300
Indianapolis, IN 46204
In Sum of$
$ 38.83
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO#or INVOICE NO. ACCT WTITLE AMOUNT Board Members
Rept#
1091 26512 4340700 $ 38.83 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
October 21,2015
Signature
$ 38.83 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund