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Home My WebLink About164394 09/30/2008 CITY OF CARMEL, INDIANA VENDOR: 00350364 Page 1 of 1 4, ONE CIVIC SQUARE PUBLIC SAFETY MEDICAL SERVICES CHECK AMOUNT: $1,665.00 �t ro CARMEL, INDIANA 46032 324 E NEW YORK ST SUITE 300 INDIANAPOLIS IN 46204 CHECK NUMBER: 164394 CHECK DATE: 9/30/2008 DEPARTMENT ACCOUNT P O NUM INVOICE NUMBER A MOUNT DESCRIPTION 1110 4340701 4859 527.00 MEDICAL EXAM FEES Cl120 4340702 9858 .210.00 SHOTS INOCULATIONS `1110 4340701 9888 928.00 EXAM FEES F f INVOICE 0 Public Safety Medical Services 324 E. New York Street 'E. Suite 300 lY Indianapolis, IN 46204 Carmel Police Department/ CARMEPD F_:" 3 Civic Square Terms Carmel, IN 46032 Invoice Date 09/1612008 Invoice 00 -09859 Date Employee Description Amount Balance Due 09/11108 Vanderbeck, David R. 10 Cities $234.00 $234.00 Treadmill (PFE) $165.00 $165.00 Flexibility Check $7.00 $7.00 Waist/Hi Ratio $0.00 $0.00 OnMed Program $10.00 sio.001 09/12/08 Smith roy D. Exec 1 Wellness 61.00 $61.00 HIV 1 2 $0.00 $0. 00 uantiferan Tb Gold $50.00 5000 es 527:00 s <Total Char Total Payments Balance Due $0':00 '$527,00 Please write invoice number on payment check. Our Federal Employer Identification Number is 35- 2079797 INVOICE 0 Public Safety Medical Services 324 E. New York Street E Suite 300 tY Indianapolis, IN 46204 0 Carmel Police Department l CARMEPD 3 Civic Square Terms Carmel, IN 46032 Invoice Date 09/23/2008 m Invoice 00 -09888 Date Employee Description Amount Balance Due 09/19108 Gerdt Andrew R 10 Cities $234.00 $234.00 OnMed Program $10.00 $10.0 0 Treadmill WE) 165.00 $165.00 Bodv Fat Check Bod Pod $23.00 $23.0 0 FlexibilitV Check $7.00 $7.00 Waist/Hi Ratio $0,00 $0.00 Quantiferon Tb Gold $50.00 $50.00 Horner Jeffrey J. 10 Cities $234.00 $234.00 OnMed Program $10.00 $10.0 0 Treadmill (PFE) S165.00 $165.001 Body F t Qheck -B P $23.00 F[exibilitv Check $7.00 $7.00 Waist/Hi Ratio $0.00 $0.00 Total °Charges $928:00: Total Payments'& Balance: Due $0:00 $928:00. Please write invoice number on payment check. Our Federal Employer Identification Number is 35- 2079797 Prescnied by State Board o1 Accounts City Form No. 201 (Rev. 1995) ACCOUNTS PAYABLE VOUCHER P 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 Public Safety Medical Services Purchase Order No. 324 E. NEw York street, Suite 300 Terms Indianapolis, IN 46204 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 9/16/08 9859 payment for officer physicals 527.00 9/23/08 9888 payment for officer physicals 928.00 Total 1,45 1 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 ublic Safety Medidal Services IN SUM OF 324 E. New York Street, Suite 300 Indianapolis, IN 46204 1,455.00 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 4859 407 -01 527.00 bill(s) is (are) true and correct and that the 1110 9888 407 -01 928.00 materials or services itemized thereon for which charge is made were ordered and received except September 24 20 08 Signature chief of POlice Cost distribution ledger classification if Title claim paid motor vehicle highway fund INVOICE r' o Public Safety Medical Services 324 E. New York Street 'E, Suite 300 d 0: Indianapolis, IN 46204 Carmel Fire Department I CARMEFD 2 Civic Square Terms m Carmel, IN 46032 Invoice Date 09116/2008 Invoice 00 -09858 Date Employee- Description,.' Amount= Balaace:Due, 09/11/08 Haus, Joshua S. HB SAb Quantitative Titer $35.00 $35.00 Hutchison, Brian P. HB SAb Quantitative Titer $35.00 $35.00 Ray. Lucas M. HB SAb Quantitative Titer $35.00 $35.00 Watts, Trent E. HB SAb Quantitative Titer $35,00 $35.00 Woodburn Scott E. HB SAb Quantitative Titer $35.00 $35.00 Young, Kevin M. HB SAb Quantitative Titer $35.00 $35.00 :Total $210x00 Total: Pa ments& Baianoe,Due. $0200" f y 210:00: Please write invoice number on payment check. Our Federal Employer Identification Number is 35- 2079797 VOUCHER NO. WARRANT NO. ALLOWED 20 Public Safety Medical Services IN SUM OF 324 East New York Street, Ste. 300 Indianapolis, IN 46204 $210.00 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO# Dept. INVOICE NO. ACCT #ITITLE AMOUNT Board Members 1120 9858 43- 407.02 $210.00 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 —orp 22nnQ Title Cost distribution ledger classification if claim paid motor vehicle highway fund 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 showy 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)) 9858 Shots for Recruits $210.00 1 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