HomeMy WebLinkAbout180847 12/30/2009 CITY OF CARMEL, INDIANA VENDOR: 00350806 Page 1 of 1
¢j ONE CIVIC SQUARE INDIANA UNIVERSITY
0
ro CARME INDIANA 46032 PO BOX 66271 CHECK AMOUNT: $650.00
oh ,e INDIANAPOLIS IN 46266 -6271 CHECK NUMBER: 180847
CHECK DATE: 12/30/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4351501 01— JH4767610 650.00 EQUIPMENT MAINT CONTR
INDIANA UNIVERSITY- PURDUE UNIVERSITY INDIANAPOLIS
INVOICE
CUSTOMER NUMBER: CAR912 IN2086267CGG INVOICE NUMBER:
CUSTOMER PO NBR: 01 JH4767610
PO DT: INVOICE DATE:
12/16/2009
PROVIDED TO: BILLED BY (DO NOT REMIT TO):
ATTN: A /P. MICHAEL D. FOGARTY INDIANA UNIVERSITY
PHARMACOLOGY TOXICOLOGY
CARMEL PD MS A401
3 CIVIC SQUARE INDIANAPOLIS IN 46202 -5120
/317 -274 -7825
CARMEL IN 46032 FAX 317- 278 -2836
INDIANA STATE DEPT. OF TOXICOLOGY 2010 BTI MAINT. PROGRAM MNNVMM 356001673
QTY UNIT ITEM DESCRIPTION UNIT PRICE EXT. PRICE
1.00 EA IM EVIDENTIARY BREATH TEST INST MAINT PROG 650.00 650.00
TERMS: NET 30 DAYS PAY THIS AMOUNT 650.00
r_ f,.
I I
f
I
1
RETAIN THIS PORTION FOR YOUR RECORDS
Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
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.
Payee
Indiana University Purchase Order No.
P.O. Box 66271 Terms
Indianapolis, IN 46266 6271 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
1 1 1 •.'u- 1 11
Total
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
Clerk- Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
Indiana University IN SUM OF
P.O. Box 66271
Indianapolis, IN 46266 -6271
650.00
ON ACCOUNT OF APPROPRIATION FOR
police genera lfund
Board Members
PT INVOICE NO. ACCT #/TITLE AMOUNT I hereby certify that the attached invoice(s), or
1110 01- JH4767610 515 -01 650.00 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
December 26 20 09
Signature
Assistant Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund