163253 09/03/2008 CITY OF CARMEL, INDIANA VENDOR: 00350172 Pagel of 1
ONE CIVIC SQUARE INDIANA UNIVERSITY
t ea CARMEL, INDIANA 46032 PO BOX 66271 CHECK AMOUNT: $320.00
o a INDIANAPOLIS IN 46265-6271 CHECK NUMBER: 163253
CHECK DATE: 913/2008
D EPARTME NT ACCO PO N UMBER INVOICE NUM AMOUNT D
1110 4357004 01HL7221809 320.00 EX'T'ERNAL INSTRUCT FEE
r_-
i INDIANA UNIVERSITY- PURDUE UNIVERSITY INDIANAPOLIS
INV9IC
CUSTOMER NUMBER: CAR912 IN2 8 267CGG INVOICE NUMBER:
CUSTOMER PO NBR: 01- HL7221809
PO DT: INVOICE DATE:
08/20/2008
PRUVIDED TO: BILLED BY (DO NOT REMIT TO):
ATTN: A /P. RE: 8 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 -017 FEIN NUMBER 35 600 1673
QTY UNIT ITEM DESCRIPTION UNIT PRICE EXT. PRICE
8.00 EA BTR BREATH TEST RECERT. ISDOT 8/4- 7/2008 40.00 320.00
GREG S. DEWALD
CHARLES V. HARTING
BRETT A. KEITH
SCOTT D. LONG
BLAKE A. LYTLE
RYAN J. MEYER._
MICHAEL G. MILLER
DONALD C. SNOW
t
TERMS: NET 30 DAYS PAY THIS AMOUNT 320.00
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Rk'VIN'INlS POTION FQR YQU RB IM 'S.............................
Pres�ribed by Slate Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
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. Box 66271 Terms
Indianapolis, IN 46266 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
8/20/08 OIHL7221809 paygent for breath test recert for Officer Greg Dewald, 320.00
Lt. Charlie Harting, Sgt. Brett Keith, Officer Scott
Long, Officer Blake Lytle, Officer Ryan Meyer, Officer
Mike Miller and Officer Don Snow
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
I ndiana University IN SUM OF
P.O. Box 66271
Indianapolis, IN 46266
320.00
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 OIHL7221809 570 -04 320.00 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
August 28 2008
Signature
Chief 6fdPolic
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund