167105 12/17/2008 CITY OF CARMEL, INDIANA VENDOR: 165570 Page 1 of 1
ONE CIVIC SQUARE IVY TECH STATE COLLEGE CHECK AMOUNT: $5,284.50
CARMEL, INDIANA 46032 ATTN: OFFICE OF THE BURSAR
PO BOX 1363
CHECK NUMBER: 167105
INDIANAPOLIS IN 46903 -1373
CHECK DATE: 12/1712008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESC
3120 4357004 12610 4923 5,284.50 MEDIC CLASS
IVY TECH COMMUNITY COLLEGE OF INDIANA Invoice No: 4923
P.O. BOX 1373 Invoice Date: 12/02/08
KOKOMO, IN 46903 -1373 Due Date: 12/22/08
Spring semester of 2009
CARMEL FIRE DEPARTMENT Please Pay: $5,284.50
ATTN: DENISE SNYDER
2 CIVIC SQUARE
CARMEL, IN 46032
PROGRAM TITLE: Paramedic Science
NUMBER OF STUDENT: 3 -Kip Benbow, James Mitchell Christopher Walker
LENGTH OF TRAINING: Course IND 50101E 01/12- 03/02/08
Course PARM 111 01/12/ 03/11/08
Course IND 50104E 03/04 05106108
Course PARM 112 03/16 05/06108
LOCATION OF TRAINING: Riverview Hospital -EMS Education Building
205 Building
395 Westfield Road
Noblesville, IN 46060
PROGRAM CHARGE: 3 $1,761.50 $5,284.50
Please return.a copy of the invoice with your remittance.
R1V 083 -01 -01
#825101812 -(s is- $3,454.50)
#ARE300067 -56- (banner $1,830.00 1815 EAST MORGAN
P.o, T BOX 1373
KOKOMO, INDIANA 46903 -1373
765- 459 -0561
FAX 765-454-5111.
1% Tcch is an accredited, equal opportunitV, allirmative action community college.
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))
4923 Medic Class x 3 $5,284.50
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
Ivy Tech Community College
IN SUM OF
P.O. Box 1373
Kokomo, IN 46609
$5,284.50
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
12610 4923 43- 570.04 $5,284.50 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
'z
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund