166863 12/10/2008 CITY OF CARMEL, INDIANA VENDOR: 00350782 Page 1 of 1
0 ONE CIVIC SQUARE RIVERVIEW HOSPITAL CHECK AMOUNT: $25.00
CARMEL, INDIANA 46032 ATfN: EDUCATION
395 WESTFIELD ROAD
CHECK NUMBER: 166863
NOBLESVILLE IN 46060
CHECK DATE: 12/10/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1046 4357004 4956073 :25.00 EXTERNAL INSTRUCT FEE
11/21/2008 10:38 FAX 3177768506 HAM CO HEALTH DEPT 12001/001
Namifl;oyt County Health Department Purchase
Description
One Hamilton County Square, Suite 30 P.O. P or F
Noblesville, In 46060 G.L.
Phone (317) 776 -6500 Budget C
Fax: (317) 776 -8508 Line Descr����
Approval Date
Heal Educati C Invoi
Invoice 4956073g�
Invoice Date 11/17/2 F ---"V NOV5 2008
Inv oice To Info Edu cational Course I
Contact: Jennifer Sewell Course Title:
Bill to: Monon Center Course Date: 11/14/2008
Location: The Monon Center
Address; 1235 Central Park Drive East
Carmel, IN 46032 Instructor: James R. Ginder,MS,EMT,PI,CHES
Cost per Student: $1 25
Billable Spaces: 20
Fee Amount: $25.00
C ertification Cards wi ll be ma iled upo re ceipt of paymen
Payment Received: (Date) Check Initial:
Please Make Payment To:
_R iverview H ospital
Retain this portion for y records
Course
Course Date 11I14I2008 Ce rtificatio n Cards will be mailed u on receipt of a ment
Fee $25.00
Printed: 11/17/2008 10:02:17
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of 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.
00350782 Riverview Hospital
Attn: Education Date Due
395 Westfield Rd
Noblesville, IN 46060
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/17/08 4956073 Health education course 25.00
Total 25.00
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
Voucher No. Warrant No.
Riverview Hospital Allowed 20
Attn: Education
395 Westfield Rd
Noblesville, IN 46060 In Sum of
'Y
25.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #[TITLE AMOUNT Board Members
Dept
1046 4956073 4357004 25.00 1 hereby certify that the attached invoice(s), or
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
1 -Dec 2008
k
Signature
25.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund