HomeMy WebLinkAbout253229 01/11/16 CITY OF CARMEL, INDIANA VENDOR: 307600
`1.
ONE CIVIC SQUARE TREASURER OF STATE CHECK AMOUNT: $*******650.00*
=Q CARMEL, INDIANA 46032 INDIANA STATE BUDGET AGENCY CHECK NUMBER: 253229
200 WEST WASHINGTON STREET SUITE 21 CHECK DATE: 01/11/16
INDIANAPOLIS IN 46204
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4351501 16ISDT-0023 650.00 EQUIPMENT MAINT CONTR
Invoice
Indiana State Department of Toxicology
To: Carmel Police Department
3 Civic Square
Carmel, IN 46032
Invoice Number: 161SDT-0023 Invoice Date: December 09, 2016
Item: 2016 Evidential Breath Test Instrument Maintenance Agreement
— - - - ---- -- ., --- —Pay this amountYou may pay online with a debit or credit card by going to: https://www.payingov.com/toxicology
If paying by check or money order, please make them payable to: Treasurer of State
Remit to: Indiana State Budget Agency
200 W. Washington Street, Rm 212
Indianapolis, IN 46204
Retain this portion for your records
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 Date Invoice# Description Amount
Dept, Fund# (or note attached invoice(s)or bili(s))
12/09/15 '161SDT-0023 evidential breath tesf instrument maintenance agreement $650.00`
1.110 101
I hereby certify that the attached invoice(s),or bill(s),is(are)true and correct and I have audited same in accordance
with IC 5-11-10-1.6
20
Clerk-Treasurer
VOUCHER NO. WARRANT NO.
:ALLOWED
20
TREASURER OF STATE
INDIANA STATE BUDGET AGENCY
IN SUM OF$
200 WEST WASHINGTON ROOM 212
INDIANAPOLIS, IN 46204
$650.00
ON ACCOUNT OF APPROPRIATION FOR
PO#/Dept. INVOICE NO. ACCT#%Fund. AMOUNT Board Members
161SDT=0023_. 43-515:01 $650.00 I:hereby certify that the attached invoice(s), or
1.110 -I: I 101,. . . I.Prior Year
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
i -
Wednesday,December 30, 2015
Cost distribution,ledger classification if.
Claim paid motor vehicle.highway fund