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HomeMy WebLinkAbout319243 11/30/17 Cqq CITY OF CARMEL, INDIANA VENDOR: 00350364 d ONE CIVIC SQUARE PUBLIC SAFETY MEDICAL SERVICES CHECK AMOUNT: $*******287.04* CARMEL, INDIANA 46032 324 E NEWFYORK ST SUITE 300 CHECK NUMBER: 319243 INDIANAPOLIS IN 46204 CHECK DATE: 11/30/17 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1120 4340701 31749 86.11 MEDICAL EXAM FEES 1120 4340701 31792 200.93 MEDICAL EXAM FEES VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) Vendor# 00350364 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER PUBLIC SAFETY MEDICAL SERVICES IN SUM OF$ CITY OF CARMEL 324 E NEW YORK ST SUITE 300 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. INDIANAPOLIS, IN 46204 Payee $200.93 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 31792 43-407.01 $200.93 1 hereby certify that the attached invoice(s),or 11/29/17 31792 $200.93 1120 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 Wednesday, November 29,2017 Uar _zA_ David Haboush Fire Chief 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 5-11-10-1.6 120— Cost 20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer Public Safety Medical - INVOICE o Public Safety Medical Invoice Date: 11/29/2017 ' • +. 324 E. New York Street Invoice# 00-31792 E Suite 300 Terms: W Indianapolis, IN 46204 r C Carmel Fire Department/CARMEFD I . Denise Snyder, Budget&Accred Mgr m Dsnyder@carmel.In.Gov(B) Exclusively Serving Public Safety Professionals Since 1990. Date Employee Description Amount Balance Due 11/13/17 Fisher,Ga L. Fit For Duty Exam(Follow UM L v 12 $200.9.3 $200.931 Total Charges-> $200.93 Total Payments&Balance Due-> $0.00 $200.93 Please write invoice number on payment check. Our Federal Employer identification number is 35-2079797. We greatly appreciate the opportunity to serve you. If you have any questions regarding this invoice, please contact Michelle McClure at 317-964-2364. VOUCHER NO. WARRANT NO. Prescribed by state Board of Accounts City Form No.201(Rev.1995) Vendor# 00350364 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER PUBLIC SAFETY MEDICAL SERVICES IN SUM OF$ CITY OF CARMEL 324 E NEW YORK ST SUITE 300 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. INDIANAPOLIS, IN 46204 Payee $86.11 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 31749 43-407.01 $86.11 1 hereby certify that the attached invoice(s),or 11/28/17 31749 $86.11 1120 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 Tuesday, November 28,2017 David Haboush Fire Chief 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— Cost 20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer Public Safety Medical - INVOICE o , Public Safety Medical Invoice Date: 11/17/2017 324 E. New York Street Invoice# 00-31749 E Suite 300 Terms: d.;. � • Indianapolis, IN 46204 o' Carmel Fire Department/CARMEFD F- Denise Snyder, Budget&Accred Mgr m Dsnyder@carmel.In.Gov(B) Exclusively Serving Public Safety Professionals Since 1990. Date Employee Description Amount Balance Due 1-11/06/17 1Fisher,Gary L, Fitness For Duty Exam l i i l Level 1 $86.11 $86.111 Total Charges->• . $86.11 Total Payments.&Balance Due-> -$0.00,1 $86.11 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 Michelle McClure at 317-964-2364.