165282 10/29/2008 CITY OF CARMEL, INDIANA VENDOR: 00350172 Page 1 of 1
ONE CIVIC SQUARE INDIANA UNIVERSITY
CARMEL, INDIANA 46032 CHECK AMOUNT: $160.00
PO BOX 66275
INDIANAPOLIS IN 46266-6271 CHECK NUMBER: 165282
CHECK DATE: 10/29/2008
D EPARTMEN T AC PO NUMBER INVO NU MBER AMOUNT DES
1110 4357004 01ET5299609 160.00 EXTERNAL INSTRUCT FEE
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INDIANA UNIVERSITY- PURDUE U INDIANAPOLIS
CUSTOMER NUMBER: CAR912 INZ0�3 INVOICE NUMBER:
CUSTOMER PO NBR: 01- ET5299609
PO DT: INVOICE DATE:
09/30/2008
PROVIDED TO: BILLED BY (DO NOT REMIT TO):
ATTN: A /P. RE: 4 ATTENDEES 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
INDIANA STATE DEPARTMENT OF TOXICOLOGY BTR ISDT 2008 -019 FEIN NUMBER 35 600 1673
QTY UNIT ITEM DESCRIPTION UNIT PRICE EXT. PRICE
4.00 EA BTR BREATH TEST RECERT. ISDOT 9/8- 11/2008 40.00 160.00
WILLIAM E. HAYMAKER
DAVID M. KINYON
AARON M. LEACH
DONALD D. SCHOEFF, JR.
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TERMS: NET 30 DAYS PAY—THIS AMOUNT 160.00
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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. Bo x66271 Terms
Indianapolis, IN 46266 -6271 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
9110109 OlET52996 for br eath test recertification 160.00
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
Indiana University IN SUM OF
P.O. Box 66271
Indianapolis, IN 46266 -6271
160.00
ON ACCOUNT OF APPROPRIATION FOR
police general fund
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. i hereby certify that the attached invoice(s), or
1110 OIET5299609 570 -04 160.00 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 22 l 20 08
Signature
Assistant Chief of Police
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund