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HomeMy WebLinkAbout332484 11/21/18 CITY OF CARMEL, INDIANA VENDOR: 372939 ECK AMOUNT: $*******140.40* ONE CIVIC SQUARE ASCENSION ST VINCENT PUBLIC SAFEPI`I CARMEL, INDIANA 46032 6612 E 75TH STREET CHECK NUMBER: 332484 �*oN SUITE 200 CHECK DATE: 11/21/18 INDIANAPOLIS IN 46250 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1110 4340701 20-34038 140.40 MEDICAL EXAM FEES VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) ALLOWED 20 ACCOUNTS PAYABLE VOUCHER Vendor# 372939 ASCENSION ST VINCENT PUBLIC SAFETY IN SUM OF$ CITY OF CARMEL 6612 E 75TH STREET An invoice or bill to be properly itemized must show:kind of service,where performed,dates service SUITE 200 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc. INDIANAPOLIS, IN 46250 Payee $140.40 ON ACCOUNT OF APPROPRIATION FOR Purchase Order# Carmel Police 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 20-34038 43-407.01 $140.40 1 hereby certify that the attached invoice(s),or 11/9/18 20-34038 officer physicals $140.40 1110 101 1110 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 20,2018 ac'.. ' lam J., Jim Barlow 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 distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer Ascension St. Vincent Public Safety Medical - INVOICE 0 Ascension St.Vincent Invoice Date: 11/09/2018 Public Safety Medical Invoice# 20-34038 E 6612 E.75th Street, Suite 200 Terms: W Indianapolis IN 46250 o Carmel Police Department/CARMEPD �- Pyoung@carmel.In.Gov A m ' Exclusively Serving Public Safety Professionals Since 1990. Date Employee - Description Amount Balance Due 11101/18 Miller Adam C. HIV-4th Gen Ra id Test Blood 26.58 $26.58 Venipuncture $3.62 $3.62 Lipid Panel Blood $24.42 $24.42 CBC(Comp Blood Count 20.80 $20.80 CMP(Comp Metabolic Panel 22.97 $22.97 PSA-Prostate Specific A Blood 42.01 $42.011 Total Charges-> $140.40' Total Payments&Balance Due-> $0.00 $140.40 Please make check payable toc ,ision =;taiVinfP�blic Safet bM dcai' and write invoice number on payment check. Our Federal Employers�Asn I Icatlon�`n�be i�6-M273 . We greatly appreciate the opportunity to serve you. If you have any questions regarding this invoice, please contact Michelle McClure at 317-964-2364.