HomeMy WebLinkAbout191248 10/27/2010 CITY OF CARMEL, INDIANA VENDOR: 00350806 Page 1 of 1
o ONE CIVIC SQUARE INDIANA UNIVERSITY CHECK AMOUNT: $650.00
CARMEL, INDIANA 46032 PO BOX 66271
INDIANAPOLIS IN 46266 -6271 CHECK NUMBER: 191248
CHECK DATE: 10/27/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4351501 01PV3457811 650.00 EQUIPMENT MAINT CONTR
s
INDIANA UNIVERSITY- PURDUE UNIVERSITY INDIANAPOLIS
CUSTOMER NUMBER* CAR912 IN 086%7CGG INVOICE NUMBER:
CUSTOMER PO NBR: 01— PV3457811
PO DT: INVOICE DATE:
10/05/2010
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
BREATH TEST INSTRUMENT MAINTENANCE 2011 FITNKMBGR 356001673
QTY UNIT ITEM DESCRIPTION UNIT PRICE EXT. PRICE
1.00 EA IM EVIDENTIARY BREATH TEST INST MAINT FROG 650.00 650.6
TERMS: NET 30 DAYS PAY THIS AMOUNT c50.vv
a
n t
x
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))
10/5/10 01—PV3457811. annual payment 650.00
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. WARRANT NO.
ALLOWED 20
Iidiana University IN SUM OF
P ?0. Box 66271
Indianapolis, IN 46266 -6271
650.00
ON ACCOUNT OF APPROPRIATION FOR
po genera fu
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. #t I hereby certify that the attached invoice(s), or
1110 OIPV3457811 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
October 18 20 10
gnature
Assistant Chief of Poli
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund