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.