159410 05/14/2008 E CITY OF CARMEL, INDIANA VENDOR: 00350172 Page 1 of 1
ONE CIVIC SQUARE INDIANA UNIVERSITY CHECK AMOUNT: $240.00
,t CARMEL, INDIANA 46032 PO BOX 66271
INDIANAPOLIS IN 46266 -6271 CHECK NUMBER: 159410
CHECK DATE: 5/1412008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4357004 OlYH7892308 240.00 EXTERNAL INSTRUCT FEE
INDIANA UNIVERSITY- PURDUE' UNIVERSITY INDIANAPOLIS
INVOICE
CUSTOMER NUMBER: CAR912 IN2086267CGG INVOICE NUMBER:
CUSTOMER PO NBR: 01 YH7892308
PO DT: INVOICE DATE:
04/16/2008
PROVIDED TO: BILLED BY (DO NOT REMIT TO):
ATTN: 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 ITINNU uiee 356901673
QTY UNIT ITEM DESCRIPTION UNIT PRICE EXT. PRICE
6.00 EA BTR BREATH TEST RECERT APRIL 7 -10, 2008 40.00 240.00
BUTTICE, JENNIFER R
GROSE, JAMES E
KINKADE, MATTHEW P
SCHMIDT, BRIAN E
SEMESTER, JAMES
STEIN, AMY J
TERMS: NET 30 DAYS PAY THIS AMOUNT 240.00
I
KI;'I'AIN THIS PORTION F0K 1'OUI� RIiCOKDS
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. Box 66271 Terms
Indinapolis, IN 46266 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
4/16/08 OIYH7892308 payment for breath test recertification 240.00
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
Ind University IN SUM OF
P.O. Box 66271
Indianapolis, IN 46266 -6271
240.00
ON ACCOUNT OF APPROPRIATION FOR
police genral'_fund
Board Members
PO# or INVOICE NO. ACCT #!TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
1110 OIYH7892308 570 -04 240.00 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
May 8 2008
1 &tk.tte b 1"a
Si nature
Chef of Police
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund