307701 01/27/17 .aa.u{.G�xr'i
�, CITY OF CARMEL, INDIANA VENDOR: 00350364
ONE CIVIC SQUARE PUBLIC SAFETY MEDICAL SERVICES CHECK AMOUNT: $"""""1,673.25"
�.?q CARMEL, INDIANA 46032 INDIANAPOLIS24ENYN s SUITE 300 CHECK NUMBER: 307701
�"��o�" CHECK DATE: 01/27/17
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4340701 100018 00-29807 1,168.94 OFFICER PHYSICALS
1120 4340701 29806 504.31 MEDICAL EXAM FEES
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Public Safety Medical - INVOICE
0 Public Safety Medical Invoice Date: 01/12/2017
324 E. New York Street Invoice# 00-29806
m Suite 300 Terms:
W Indianapolis, IN 46204
G Carmel Fire Department/CARMEFD
F- Denise Snyder, Budget&Accred Mgr
m 2 Civic Square(PO#24831)
Carmel, IN 46032
Exclusively Serving Public Safety Professionals Since 1990.
Date Employee Description Amount Balance Due
01/04/17 Johnson Jeremy Fitnes F r D Exam(initial)Level 1 .11 $86.11
Comprehensive Physical Exam $102.46 $102.46
01/05/17 Robinson Mark G. Fitness For Duty Exam Initial Level 3 $315.74 $315.74
Total Charges-> $504.31
Total Payments&Balance Due->1 $0.001 $504.31
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.