HomeMy WebLinkAbout164083 09/23/2008 CITY OF CARMEL, INDIANA VENDOR: 361803 Page 1 of 1
r ONE CIVIC SQUARE PESI HEALTHCARE
CARMEL, INDIANA 46032 P.O. Box 900 CHECK AMOUNT: $328.00
EAU CLAIRE WI 54702 CHECK NUMBER: 164083
CHECK DATE: 9/23/2008
DEPARTMEN ACCOUNT PO NUMBER INVOICE NUMBER A MOUN T DESCRIPTION
1120 4357004 804915 328.00 EXTERNAL INSTRUCT FEE
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f
I
PE W Proforrna Registration Invoice
Healthcare
IN Life Threatening Pediatric Emergencies (38052)
INDIANAPOLIS, IN 9/12/2008
CITY OF CARMEL
1 CIVIC SQ
CARMEL, IN 46032
PO Number: 12574
Order: 804915
ate
De s'cr�pt�o..n R Qt Y Charg
FISHER, GARY
(2+ Group Rate: per person) $164.00 1 164.00
164.00
LANZA,TED
(2+ Group Rate: per person) $164.00 1 164.00
164.00
328.00
Net: 328.00
Please Remit To:
PESI HealthCare
P.O. Box 900
Eau Claire, WI 54702 -0900
Phone: 1 -800- 843 -7763
Email: info @pesihealthcare.com
Fed ID 39- 2033621
Order Number ER Account Charges Credits Due
804915 00669276 328.00 0.00 328.00
CEM315 Page 1 of 1 PEST HealthCare (10), 09/05/2008 8:03 AM
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))
Regis. Fees Fisher, Lenze $328.00
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
P ES I ff t 44 4_CA rZ
IN SUM OF
�j �jc boo
claZ,(L LA//
$328.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1120 43- 570.04 $328.00 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
SEP 15 2008
17 _d
a
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund