158594 04/15/2008 CITY OF CARMEL, INDIANA VENDOR: 00350364 Page 1 of a
ONE CIVIC SQUARE PUBLIC SAFETY MEDICAL SERVICES
i CHECK AMOUNT: $575.00
CARMEL, INDIANA 46032 324 E NEW YORK ST SUITE 300
«o INDIANAPOLIS IN 46204 CHECK NUMBER: 158594
CHECK DATE: 4/15/20
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4340701 0008954 500.00 MEDICAL EXAM FEES
1120 4340701 9005 75.00 MEDICAL EXAM FEES
II
INVOICE
Public Safety Medical Services
324 E. New York Street
!E: Suite 300
sm;
Indianapolis, IN 46204
Carmel Fire Department 1 CARMEFD
2 Civic Square Terms
Carmel, IN 46032 Invoice Date 04/09/2008
Invoice 00 -09005
Description Amount+ $alance(Due'
03/31/08 VanVoorst, Robert J. Fitness For Dut Level 1 $75.00 $75.00
ro
bt* To
arges $75:00
�Total�RLin nts. &�Balance`Due $0:00 $75.00:
Please write invoice number on payment check.
Our f=ederal Employer Identlflcation 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
$75.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# /Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
1120 9005 43 -407,01 $75.00 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
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 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))
04/09/08 9005 Fitness for Duty VanVoorst $75.00
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
INVOICE
0 Safety Medical Services
324 E. New York Street
Ew' Suite 300
C pN
5 0I Indianapolis, IN 46204
o a Carmel Police Department I CARMEPfl
Terms
3 Civic Square
1 Carmel, IN 46032 Invoice Date 03/31/2008
Invoice 00 -08954
Date ^:.Employee,:° z, Description`' Amount Balance >Due
03/13/08 Collins, Shane P. Exec 1 Wellness Offsite $61.00 $61.00
03/24/08 Towle John R. 10 Cities 234.00 $234.00
Treadmill (PFE) $165.00 165.00
Body Fat Check Bod Pod $23.00 $23.0 0
Flexibilitv Check $7.00 7.00
Waist/Hi Ratio $0.00 0.00
OnMed Program 10.00 10.00
5
R a� r .•fx Q, s' ,a'S .Q 9' E,Charge5 'r�$500i00g 'vx
s S l ytx Y "Y i .,y,, S, ..T p F'f `e i .i Y 4 7�. t'
Tota ayrr
l Aients. &'Salance: `Duef>
$0 :00, �y c
Please write invoice number on payment check.
Our Federal Employer Identification Number is 35- 2079797
Prescrtoed 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
Public Sagety Medical Services Purchase Order No.
324 E. New York St
Suite 300 Terms
'Indpls, IN 46204
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
3/31/2008 0008954 payment for officer physicals 500.00
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
0U HER NO. WARRANT NO.
ALLOWED 20
Public Safety Medical Services IN SUM OF
324 E. New York St
Suite 300
Indpls, IN 46204
500.00
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 0008954 407 -01 500.00 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
April 10, 2008
I
Signature
Chief Af police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund