163377 09/03/2008 CITY OF CARMEL, INDIANA VENDOR: 00350782 Page 1 of 1
ONE CIVIC SQUARE RIVERVIEW HOSPITAL
e t )a CARMEL, INDIANA 46032 ATTN: EDUCATION CHECK AMOUNT: $20.00
ROAD WESTFIELD
395
CHECK NUMBER: 163377
NOBLESVILLE IN 46060
CHECK DATE: 9/3/2008
DE PARTMENT ACCOUNT P O NUMBER INV NUMBER AMOUNT DESCRIPTION
1046 4357004 4794698 20.00 EXTERNAL INSTRUCT FEE
Hamilton County Health Department
3 One Hamilton County Square, Suite 30
Noblesville, In 46060 RFGFTV -FT`'
i':T ,13YT
Phone: (317) 776 -8500 AUG 1 3 '2008
Fax: (317) 776 -8506
v.
Health Education Course Invoice CEIVED
Invoice 4794698 AU 1 2008
Invoice Date 8/12/2008 BY:
Invoice To Information Educational Course Information
Contact: Jennifer Sewell Course Title: Heartsaver A,C,& I/ Pedric First Aid
Bill to: Monon Center Course Date: 8/11/2008
Location: Monnon 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: 16
Fee Amount: $20.00
Certification Cards will be mailed upon receipt of payment
Official Use.Only
Payment Received: (Date) Check Initial:
Please Make Payment To:
Purchase Riverview Hospital
Description L.
P or F Payment with Copy of Invoice to
a.t_:
Bud et Riverview`Hospital
Une X�e e S`b•� �,�1`f
�'C��- Attn aEducation;"
Purchaser Die 0��,:, :395 Westfield Rd 1.
APP Date 6 Nob1esville 46060
Retain this portion for you records
Course Heartsaver A,C,&
Course Date 8/11/2008 Certification Cards will be mailed upon receipt of payment
Fee $20.00
Printed: 8/12/2008 12:18:56
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.
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
8112/08 4794698 Educational course 20.00
Total 20.00
i hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and I have audited same in accordance
with 1C 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
20.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE= NO. ACCT#1TITLE AMOUNT Board Members
Dept
'1046 4794698 4357004 20.00 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
18 -Aug 2008
Signature
20.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
I