HomeMy WebLinkAbout200414 08/17/2011 a CITY OF CARMEL, INDIANA VENDOR: 354683 Page 1 of 1
ONE CIVIC SQUARE E M S A R INDIANA
M CHECK AMOUNT: $692.00
CARMEL, INDIANA 46032 6745 PAYNE ROAD
INDIANAPOLIS IN 46203 CHECK NUMBER: 200414
CHECK DATE: 8/17/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4350900 SI -11095 692.00 OTHER CONT SERVICES
EMSAR Indiana
6745 E. Payne Rd. Invoice
Indianapolis, IN 46203
(317) 697 -0510
(31.7} 788 -8550 Fax Customer Number :Date Invoice Number
00052 8/5 12011 ISM 1095
Bill To: Ship To:
Carmel Fire Department/24 Carmel Fire Department/24
Carmel Fire Department 2 Civic Square Attn: Carmel Fire Department
Accounts Payable 2 Civic Square
Carmel, IN 46032 Attn: Accounts Payable
Carmel, IN 46032
Ship Via Terms Due Date Sales Rep Customer PO Original Order Number
UPS Ground Due on Receipt 8/5/201.L_ 65179
Item No Qty BIO Ship Description Sales Price Disc Total
PM-STRYKER 2 0 2 PREVENTIVE MAINTENANCE STRYKER 90.00 0% 180.00
EMS
PM-STRYKER 4 0 4 PREVENTIVE MAINTENANCE STRYKER 125.00 0% 500.00
EMS
MILEAGE STR 24 0 24 MILEAGE STRYKER EMS 0.50 0% 12.00
EMS
Total Item Count: 3 Total Items Shipped: 30
Subtotal: 692,00
Freight: 0.00
Tax: 0.00
Total: 692.00
Amount Due: 692.00
Page 1
VOUCHER NO. WARRANT NO.
ALLOWED 20
EMSAR Indiana
IN SUM OF
6745 Payne Road
Indianapolis, IN 46203
$692.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. I ACCT #/TITLE AMOUNT Board Members
1120 I SI -11095 I 43- 509.00 $692.00 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
AUG 15
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle 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))
S I -11095 $692.00
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