HomeMy WebLinkAbout165304 10/29/2008 CITY OF CARMEL, INDIANA VENDOR: 00353243 Page 1 of 1
ONE CIVIC SQUARE MICHAEL A. KAUFMAN MD
CARMEL, INDIANA 46032 5245 NORTH CO. ROAD 600 EAST CHECK AMOUNT: $4,000.00
BROWNSBURG IN 46112
CHECK NUMBER: 165304
CHECK DATE: 10/2912008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4357003 4,000.00 INTERNAL INSTRUCT FEE
FROM FRX NO. :8588718 Oct. 13 2008 12:52PM P2
Invoice
Appropriation 570 -03
P.O. 1.2455
Date: 9/29/2008
Name of C0111puny: Michael A. Kaufmann, M.D.
Address /Zip: 5245 North Co. Rd. 600 East
Erownsburg, Indiana 461.12
Telephone No.: 317- 858 8471
Fax No.: 317-958-8718
Project Name: EMS Medical Direction
Invoice No:
Goods /Services Provided.:
'Prep and :Delivery of monthly A/R at CFD
Direct Medical Oversight /Observation. of Paramedics
General Training 'and Education, EMS Runs
Review rein sheets, ATLS Course "Renewal
Meetings with EMS Chief, TEMS Meetings
Date airs
May 2008 Mrs
June 2008 8111-s
July 2008 8hrs
.August 2008 8hrs
September 2008 8hrs
GRAND .TOTAL 40 hours
X
Signature
Michael A.. Kaufmann M.D.
Printed Name
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))
MD Fees $4,000.00
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
Michael Kaufmann, MD
IN SUM OF
5245 North Co. Road 600 East
Brownsburg, IN 46112
$4,000.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1120 43- 570.03 $4,000.00 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
OCT 2 7 2008
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund