HomeMy WebLinkAbout319666 12/15/17 1J ur'C.1y�F
4� CITY OF CARMEL, INDIANA VENDOR: 00350364
ONE CIVIC SQUARE PUBLIC SAFETY MEDICAL SERVICES CHECK AMOUNT: $'"*"`"75.00"
CARMEL, INDIANA 46032 324 E NEW YORK ST SUITE 300 CHECK NUMBER: 319666
'•biroN_��.` INDIANAPOLIS IN 46204 CHECK DATE: 12/15/17 '
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4340701 31867 75.00 MEDICAL EXAM FEES
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
Vendor# 00350364 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
PUBLIC SAFETY MEDICAL SERVICES IN SUM OF$ 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
$75.00
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
31867 4 .99 $75.00 1 hereby certify that the attached invoice(s),or 12/8/17 31867 $75.00
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
Friday, December 08,2017
V4M _ --,-�q,
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
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: 12/07/2017
r 324 E. New York Street Invoice# 00-31867
E Suite 300 Terms:
Indianapolis,IN 46204
Carmel Fire Department/CARMEFD
P Denise Snyder, Budget&Accred Mgr
m Dsnyder@carmel.In.Gov(B)
Exclusively Serving Public Safety Professionals Since 1990.
Date Employee Description Amount Balance Due
12/01117 Fisher L. ClearPath-RTW Eva] $75.00 S75 Qj
Total Charges-> $75.00
Total Payments&Balance Due-> $0.001 $75.00
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.