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258545 05/10/16
+u,.C�qM �/ '• CITY OF CARMEL, INDIANA VENDOR: 353880 ® "; ONE CIVIC SQUARE TELAMON CORP CHECK AMOUNT: $*******394.94* :. :° CARMEL, INDIANA 46032 1000 E 116TH ST CHECK NUMBER: 258545 tM�r6N�o` CARMEL IN 46032 CHECK DATE: 05/10/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 252 5023990 110481 394.94 OTHER EXPENSES VOUCHER NO. WARRANT NO. Prescribed by state Board of Accounts City Form No.201(Rev.1995) ALLOWED 20 ACCOUNTS PAYABLE VOUCHER TELEMON CORP 1000 E 116TH ST IN SUM OF$ CITY OF CARMEL An invoice or bill to be properly itemized must show:kind of service,where performed,dates service rendered,by CARMEL,IN 46032 whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc. $394.94 Payee Purchase Order No. ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Terms Date Due Invoice Date Invoice# Description Amount PO#/Dept. INVOICE NO. ACCT#/Fund AMOUNT Board Members Dept. Fund# (or note attached invoice(s)or bill(s)) 110481 I 50-239.90 I $394.94 1 hereby certify that the attached invoice(s),or 04/29/16 110481 $394.94 252 252 252 252 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 Monday,May 02,2016 )04'ar 'ZS. David Haboush Fire Chief Cost distribution ledger classification if I hereby certify that the attached invoice(s),or bill(s),is(are)true and correct and I have audited same in accordance claim paid motor vehicle highway fund with IC 5-11-10-1.6 ,20 Clerk-Treasurer pipt PLLnd © r INVOICE h t Tel000amon6tCorporation Number: 110481 Date: 14-MAR-16 n 1 E 11 Street Carmel,IN 46032 USA SO#: Project#/RID#: Project Name: Salesperson: Customer: CFD-TMS Sold To Ship To Attn:Accounts Payable CARMEL FIRE DEPARTMENT 2 CIVIC SQUARE CARMEL IN 46032 Customer P.O. Ship Via Due Date Terius 28-APR-16 Net 45 Days Line Itemi Zescription UomantitvUnit PriceTax �Tot6l,NLt- Rate 1 MIH-CP Per Patient-Obs 11 30.38 334.18 Avoidance 2 MIH-CPPer Patient- BLS 1 30.38 30.38 Intervention 3 MIH-CP Per Patient-ALS 1 30.38 30.38 Intervention Tax Total 0.00 _ _ Freight Total : 0.00 Trade.Discount:, 0.00 Total0.00 Ad"stmefitTax-J, 0.00 7r �77' Adjustment,Freight Total 0.00 Payment/Credit, 0.00 71- invoice�Totaf 394.94 Please Pay this Amount: 394.94 Remit Address: Telamon Corporation Regions Bank, MSC 410757 P.O.Box 415000 Nashville,TN 37241-0757 US