189450 08/31/2010 CITY OF CARMEL, INDIANA VENDOR: 364656 Page 1 of 1
0 tl ONE CIVIC SQUARE NORTHWEST RADIOLOGY NETWORK CHECK AMOUNT: $22.00
CARMEL, INDIANA 46032 13583 COLLECTION CENTER DRIVE
oX co CHICAGO IL 60693 CHECK NUMBER: 189450
CHECK DATE: 8/31/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1205 4347500 000428475NW 22.00 GENERAL INSURANCE
VOUCHER NO. WARRANT NO.
ALLOWED 20
Northwest Radiology Network
IN SUM OF
13583 Collections Center Drive
Chicago, IL 60693
$22.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Administration
PO# Dept. INVOICE NO. ACCT #!TITLE AMOUNT Board Members
1205 I 000428475nw 43- 475.00 $22.00 1 hereby certify that the attached invoice(s), or
I 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
Monday, August 30, 2010
Director, A dministratio
Title
Cost distribution ledger classification if
claim paid motor vehicl highway fund
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
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
08/25/10 1 000428475nw I I $22.00
1 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