HomeMy WebLinkAbout332702 11/21/18 CITY OF CARMEL, INDIANA VENDOR: 370694
® ONE CIVIC SQUARE MICHAEL A. KAUFMANN MD CHECK AMOUNT: $*****8,000.00*
CARMEL, INDIANA 46032 5245 N COUNTY ROAD 600 EAST CHECK NUMBER: 332702
9 BROWNSBURG IN 46112 CHECK DATE: 11/21/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4357003 0 8,000.00 INTERNAL INSTRUCT FEE
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
Vendor# 370694 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
MICHAEL A. KAUFMANN MD IN SUM OF$ CITY OF CARMEL
5245 N COUNTY ROAD 600 EAST 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.
BROWNSBURG, IN 46112
Payee
$8,000.00
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
0 43-570.03 $8,000.00 1 hereby certify that the attached invoice(s),or 11/18/18 0 Medical Director Fees $8,000.00
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
Sunday, November 18,2018
Dam Dr '-Z S- -:;7��--,�A
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 distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer
Invoice
Appropriation# 570-03
P.O. Box# 12455
Date: 11/8/2018 Q1, Q2, Q3+
Name of Company: Michael A. Kaufmann, M.D.
Address/Zip: 5245 N County Road 600 East
Brownsburg, Indiana 46112
Telephone: 317-858-8471
Fax: 317-858-8718
Project Name: EMS Medical Direction
Services Provided:
Monthly chart review and audit of medical care provided by CFD
Preparation and delivery of CQI report and monthly review
Direct medical oversight/observation of paramedics
General training and education
Administrative meetings as requested
Mobile Integrated Health Special Project
Dementia Friends and IDN project
Special ACLS, PALS Course Delivery
Date Hours
January 8
February 8
March 8
April 8
May 8
June 8
July 8
August 8
September 8
October 8
Grand Total 80 k oa = g o 0 0 0
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Michael A.Kauffilann,M.D.