HomeMy WebLinkAbout252708 12/15/15 ,CAA
u ';� CITY OF CARMEL, INDIANA VENDOR: 366749
d `31 ONE CIVIC SQUARE MALINOWSKI CONSULTING INC CHECK AMOUNT: $*****9,500.00*
CARMEL, INDIANA 46032 755 W CARMEL DRIVE STE 203 CHECK NUMBER: 252708
9.y,�roN�o.= CARMEL IN 46032 CHECK DATE: 12/15/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 R4350900 24587 20150300 9,500.00 MEDICAID REPORTING
it malcon
MALINOWSKI CONSULTING, INC.
Invoice
Date: 12/3/2015 Invoice #: 20150300
To:
Chief Dave Haboush
City of Carmel-Fire Department
2 Civic Square, Station 41
Carmel, IN 46032
For Professional Services
Rendered:
For preparation of Medicaid Ambulance Cost Report for the Year Ended December 31,
2013.
Per negotiated specifications.
Total invoice amount .................. $9,500.00
Invoices are due in full 45 days of receipt. Please make all checks payable to:
Malinowski Consulting, Inc.
...............................................................................................................................................................................................
755 W Carmel Drive,Suite 203 1 Carmel,IN 46032
TEL 317.818.1876 Fax 877.346.7986 www malconindiana.com
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))
20150300 $9,500.00
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
Malinowski Consulting
IN SUM OF $
755 West Carmel Drive, Ste. 300
Carmel, IN 46032
$9,500.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
24587 20150300 43-509.00 $9,500.00 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
DEC 1 4 2015
n
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund