161158 06/25/2008 o. Cam. CITY OF CARMEL, INDIANA VENDOR: 00350782 Page 1 of 1
0 ONE CIVIC SQUARE RIVERVIEW HOSPITAL
CARMEL, INDIANA 46032 ATfN: EDUCATION CHECK AMOUNT: $6.25
395 WESTFIELD ROAD CHECK NUMBER: 161158
w NOBLESVILLE IN 46060
CHECK DATE: 6/25/2008
DEPARTMENT ACCOUNT PO NUMBER INVOIC NUMBER AMOU DESCRIPTION
1046 4357004 4669022 6.25 EXTERNAL INSTRUCT FEE
Hamilton County Health Department
One Hamilton County Square, Suite 30
Noblesville, In 46060 7MA Phone: (317) 776 8500 y Fax: 317 776 -8506 2.4 2no8
A U BY:
`-A Health Education Course Invoice
CK����
Invoice 4669022
V Invoice Date 5/27/2008
L Invoice To Information Educational Course Information
Contact: Jennifer Sewell Course Title: Heartsaver FA
Bill to: Monon Center Course Date: 5/23/2008
Location: Mon 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: 5
Fee Amount: $6.25
Certification Cards will be mailed upon receipt of payment
Official Use�Only:`
Payment Received: (Date) Check Initial:
Please Make Payment To:
Riverview Hospital CEi IVED
y JUN 0 4
Send,'Pa ment with Copy of;lnvoice to; 2��$
Riverview,Hospital BY:
Aftn Educatibn
395 Westfield Rd
Noblesville .In 46060
Retain this portion for you records
Course Heartsaver FA
Course Date 5/23/2008 Certification Cards will be mailed upon receipt of paymen
Fee $6.25
Printed: 5/27/2008 08:45:39
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
Riverview Hospital Purchase Order No.
Attn; Education
395 Westfield Rd Date Due
Noblesville, IN 46060
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
5/27/08 4669022 Heartsaver FA course, J. Sewell 6.25
Total 6.25
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
6.25
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1046 4669022 4357004 6.25 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
20 -Jun 2008
Signature
6.25 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund