185802 05/26/2010 a CITY OF CARMEL, INDIANA VENDOR: 00350806 Page 1 of 1
ONE CIVIC SQUARE INDIANA UNIVERSITY
'3 CHECK AMOUNT: $120.00
CARMEL, INDIANA 46032 PO BOX 66271
INDIANAPOLIS IN 46266 -6271 CHECK NUMBER: 185802
CHECK DATE: 5/26/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
210 4357000 INU8548510 120.00 TRAINING SEMINARS
INDIANA UNIVERSITY- PURDUE UNIVERSITY INDIANAPOLIS
INVOICE
CUSTOMER NUMBER: CAR912 IN2086267CGG INVOICE NUMBER:
CUSTOMER PO NBR: 01 NUS548510
PO DT: INVOICE DATE:
05/10/2010
PROVIDED TO: BILLED BY (DO NOT REMIT TO):
ATTN: A /P. RE: 3 ATTENDEES INDIANA UNIVERSITY
PHARMACOLOGY TOXICOLOGY
CARMEL PD MS A401
3 CIVIC SQUARE INDIANAPOLIS IN 46202 -5120
/31.7- 274 -7825
CARMEL IN 46032 FAX 317- 278 -2836
INDIANA STATE DEPT. OF TOXICOLOGY BTR-- 2010 -004 eemNUMBER 35600i673
QTY UNIT ITEM DESCRIPTION UNIT PRICE EXT. PRICE
3.00 EA BTR BREATH TEST RECERT. ISDOT APR. 1 -30, 10 40.00 120.00
JAMES E. GROSE
MATTHEW P. KINKADE
AMY J. STEIN
TERMS: NET 30 DAYS PAY THIS AMOUNT 120.00
3
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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))
5/10/10 1NU8548510 payment for breath test recert for Sgt. Amy Stein 120.00
Det. Matt Kinkade and Det. Jim Grose
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
120.00
ON ACCOUNT OF APPROPRIATION FOR
rent ed fund
Board Members
PO# or
DE r. INVOICE NO. ACCT #/TITLE AMOUNT I hereby certify that the attached invoice(s), or
210 1NU8548510 570 120.00 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
May 17 20 10
Signature
Assistant Chief of Poli
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund