186973 06/23/2010 CITY OF CARMEL, INDIANA VENDOR: 236175 Page 1 of 1
0 ONE CIVIC SQUARE PARKSIDE ANIMAL HOSPITAL
CARMEL, INDIANA 46032 12962 PUBLISHERS DRIVE CHECK AMOUNT: $51.63
FISHERS IN 46038 CHECK NUMBER: 186973
CHECK DATE: 6/23/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4357600 119150 51.63 ANIMAL SERVICES
PARKSIDE ANIMAL HOSPITAL Account: 322
12962 Publishers Drive Invoice: 119150
Fishers, IN 46038 Date: 06/04/2010
(317)' 849 -1440 Time: 3:17 PM
Page: 1
Carmel Police De Patient: WAZIR Age: N/A
3 Civic Square Species: Canine Sex: ML
Carmel IN 46032 Breed: Tag:
Color: Weight: 65.00
Doctor: Craig Johnson, D.V.M.
Phone: (317)571 -2500 (317)571 -2512
Date Service!Item Qty Price ",mount
06/04/2010 Cephalex 500 Mg Caps 14.00 1.82 25.42
06/04/2010 Exam Recheck 1.00 26.21 26.21
Tax 0.00
Net Invoice 51.63
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
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
Parkside Animal Hospital Purchase Order No.
12962 Publishers Drive Terms
Fishers, IN 46038 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
6 /4/10 119150 payment for animAl services for Wazir 51.63
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
Farkside Animal Hospital IN SUM OF
12962 Publishers Drive
Fishers, IN 4W3
51.63
ON ACCOUNT OF APPROPRIATION FOR
police general fund
Board Members
INVOICE NO. ACCT #/TITLE AMOUNT I hereby certify that the attached invoice(s), or
1110 119150 576 51.63 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 15 20 10
Aim� r
Signature
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund