HomeMy WebLinkAbout186878 06/23/2010 CITY OF CARMEL, INDIANA VENDOR: 00350806 Page 1 of 1
a; ONE CIVIC SQUARE INDIANA UNIVERSITY CHECK AMOUNT: $40.00
CARMEL, INDIANA 46032 PO Box 66271
`o INDIANAPOLIS IN 46266 -6271 CHECK NUMBER: 186878
CHECK DATE: 6123/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
210 4357000 1HV2116810 40.00 TRAINING SEMINARS
INDIANA UNIVERSITY- PURDUE UNIVERSITY INDIANAPOLIS
INVOICE
CUSTOMER NUMBER: CAR912 IN2086267CGG INVOICE NUMBER:
CUSTOMER PO NBR: 01 HV2116810
PO DT: INVOICE DATE:
06/03/2010
PROVIDED TO: BILLED BY (DO NOT REMIT TO):
ATTN: 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 BTR 2010 005 FEIN NUMBER 356001673
QTY UNIT ITEM DESCRIPTION UNIT PRICE EXT. PRICE
1.00 EA BREATH TEST RECERTIFICATION ADAM C. 40.00 40.00
MILLER
TERMS: NET 30 DAYS r PAY THIS AMOUNT 40.00
tT
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RETAIN THIS PORTION FOR YOUR RECORDS
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
t' 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.0 B1 x66217 Terms
Indianapolis, IN 46266 -6271 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
6/3/10 1HV2116810 a for breath test recert for Sgt. Adam Miller 40.00
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._, iNARRANT NO.
ALLOWED 20
I ndiana University IN SUM OF
P.O. Box 66271
Indianapolis, IN
40.00
ON ACCOUNT OF APPROPRIATION FOR
cont ed fund
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
210 IHV2116810 570 40.00 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
June 14 20 IO
Signature
Chief 6f
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund