162800 08/20/2008 CITY OF CARMEL, INDIANA VENDOR: 00350172 Page 1 of 1
0 ONE CIVIC SQUARE INDIANA UNIVERSITY CHECK AMOUNT: $120.00
CARMEL, INDIANA 46032 PO BOX 66271
INDIANAPOLIS IN 46266 -6271 CHECK NUMBER: 162800
CHECK DATE: 8/20/2008
'3EPARTM ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4357004 01- FX5377309 80.00 EXTERNAL INSTRUCT FEE
852 5023990 01- FX5377309 40.00 OTHER EXPENSES
i
INDIANA UNIVERSITY- PURDUE UNIVERSITY INDIANAPOLIS
INVOICEE
CUSTOMER NUMBER: CAR912 IN2086267CGG INVOICE NUMBER:
CUSTOMER PO NBR: 01- LX5377309
PO DT: INVOICE DATE:
08/06/2008
PROVIDED TO: BILLED BY (DO NOT REMIT TO):
ATTN: A /P. RE: 3 ATTENDEE_`; PER L=S INDIANA UNIVERSITY
PHARMACOLOGY TOXICOLOGY
CARMEL PD MS A401
3 CIVIC SQUARE INDIANAPOLIS IN 46202 -5120
/317- 274 -7825
CARMEL IN 46= FAX 317 -278 -2836
INDIANA STATE 'DEPARTMENT OF TOXICOL,OG'r' ISDT 2008 -015 ITI- NMNIAT 356001673
QTY UNIT ITEM DESCRIPTION UNIT PRICE EXT. PRICE
3.00 EA BTR BREA --H -EST REC °R.". ISDOT 7/7- 10/2008 40.00 120.00
WEND`_' Y. 30DEN!:0PN
TODD L. CASE
MICHAEL i'•,. P- ^"..y,,.
TERMS: NET 3C DAYS PAY -THIS AMOUNT 120.00
RETAIN THIS PORTION FOR YOUR RECORDS
Prescribed by Slate 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
In diana-:University Purchase Order No.
PO Box 66271 Terms
Indpls, IN 46266 -6271 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
8/6/2008 01— FX5377309 payment for breath test recert. 120.00
Officers: Bodenhorn, Case, Pitman
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
PO Box 66271
Indpls, IN 46266 -6271
120.00
ON ACCOUNT OF APPROPRIATION FOR
police general fund
Board Members
PO# or
DEPT. INVOICE NO. ACCT #/TITLE AMOUNT I hereby certify that the attached invoice(s), or
1110 01- FX537730 570 -04 bill(s) is (are) true and correct and that the
materials or services itemized thereon for
Q which charge is made were ordered and
received except
August 13, 20 08
Signature
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund