HomeMy WebLinkAbout156779 02/21/2008 A4 CITY OF CARMEL, INDIANA VENDOR: 00350364 Page 1 of 1
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ONE CIVIC SQUARE PUBLIC SAFETY MEDICAL SERVICES
CARMEL, INDIANA 46032 stn e NEW YORK sr suire 300 CHECK AMOUNT: $952.00
INDIANAPOLIS IN 46204 CHECK NUMBER: 156779
CHECK DATE: 212112008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4340701 8662 952.00 MEDICAL EXAM FEES
i.
INVOICE
Public Safety Medical Services
f—..
324 E. New York Street
Suite 300
Indianapolis, IN 46204
Carmel Police Department CARMEPD Terms
3 Civic Square Invoice Date 02/06/2008
Carmel, IN 46032 Invoice 00 -08662
Descripticn ,.s' .t ;Amount_. t:Balance`i'
01/31/08 Stites, William R. Exec 1 Wellness Offsite $61.00 $61.00
PSA $36.00 $36.00
02/01/08 Hobson Phillip L. 10 Cities $234.00 $234.00
Treadmill PEE $165.00 $165.00
Bodv Fat Check Sod Pod $23.00 $23.00
Flexibility Check 7.00 $7.00
Waist/Hi Ratio $0.00 $0.00
OnMed Program $10.00 $10.0 0
Zellers Timothy V. OnMed Program $10.00 $10.0 0
10 Cities 234.00 234.00
Tr d ill (PFE $165.0 16 0
Flexibility Check $7.00 $7,00
Waist/Hi Ratio $0.00 $0.00
_:Total Charges r ?$952100
;Total:Payments &`8alance:'Due $0:00 s> `$952:00
Please write invoice number on payment check.
Our Federal Employer Identification Number Is 35- 2079797
Prescribed by Slate Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
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
PubA 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))
216109 8662 for officernphysicals 952.00
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
Publ Safety Medical Services IN SUM OF
324 E. New York Street, Suite 300
Indianapolis, In 46204
952,.00,
ON ACCOUNT OF APPROPRIATION FOR
p olice general fund
Board Members
PO# or INVOICE NO. ACCT #!TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
1 1662 407 -01 952.00 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
February 15 2008
Signature
Chief of Police
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund