HomeMy WebLinkAbout260254 06/28/16 Q
CITY OF CARMEL, INDIANA VENDOR: 370694
ONE CIVIC SQUARE MICHAEL A. KAUFMANN MD CHECK AMOUNT: $*****4,800.00*
CARMEL, INDIANA 46032 5245 N COUNTY ROAD 600 EAST CHECK NUMBER: 260254
BROWNSBURG IN 46112 CHECK DATE: 06/28/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4357003 061016 4,800.00 INTERNAL INSTRUCT FEE
VOUCHER NO. WARRANT NO. Prescribed by state Board of Accounts City Form No.201 (Rev.1995)
MICHAEL A. KAUFMANN MD ALLOWED 20 -ACCOUNTS PAYABLE VOUCHER
5245 N COUNTY ROAD 600 EAST IN SUM OF$ CITY OF CARMEL
An invoice or bill to be properly itemized must show:kind of service,where performed,dates service
BROWNSBURG, IN 46112 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
$4,800.00 Payee
Purchase Order#
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Terms
Date Due
PO# ACCT# DATE INVOICE* DESCRIPTION
DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT
0 43-570.03 $4,800.00 1 hereby certify that the attached invoice(s),or 6/17/16 0 $4,800.00
1120 r •�� 101 1120 101
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,June 20,2016
David Haboush
Fire Chief
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
Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer
Invoice
Appropriation# 570-03
P.O. Box# 12455
Date: 6/10/2016—Q1 and Q2 2016
Name of Company: Michael A. Kaufmann, M.D.
Address/Zip: 5245 N County Road 600 East -
Brownsburg, Indiana 46112
Telephone: 317-858-8471
Fax: 317-858-8718
Project Name: EMS Medical Direction
Services Provided:
Monthly chart review and audit of medical care provided by CFD
Preparation and delivery of CQI report and monthly review
Direct medical oversight/observation of paramedics
General training and education
Administrative meetings as requested
Mobile Integrated Health Special Project
Date Hours
January 8
February 8
March 8
April 8
May 8
June 8
Grand Total 48
v®o0 00
X ..�
Michael A. Kaufma ,M.D.