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HomeMy WebLinkAbout204137 12/06/2011 CITY OF CARMEL, INDIANA VENDOR: 365547 Page 1 of 1 ONE CIVIC SQUARE ANIMAL DERMATOLOGY CLINIC INDIAN AMOUNT: $76.00 CARMEL, INDIANA 46032 3901 E 82ND ST a o INDIANAPOLIS IN 46240 CHECK NUMBER: 204137 CHECK DATE: 12/612011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1110 4357600 8626 76.00 ANIMAL SERVICES Animal Dermatology Clinic Indianapolis 3901 E. 82nd St Bill for Services Indianapolis, IN 46240 DATE INV. NUM Tel: 317- 578 -7773 11/28/11 8626 Dave Lora Kinyon 15482 Border Dr Noblesville, IN 46060 Acct no.: 963 Lori Thompson DVM ACVD Qty Date Patient Description Staff Price Ext Tx 1 11/28/20111 Wazir EX1152- Medical Progress Exa LT $58.00 $58.00 1 111l128/2011 Wazir I RxS9999- Script Tetrac !I LT SO.001 S0.001 1 L 1001 Wazir I PP0911- Niacinamide LT S0.18� S18.00 Subtotal $76.00 Tax 0.00 Pmnt 1: Amt: $0.00 Bill total $76.00 Note: Prev balance $0.00 Pmnt 2: Amt: $0.00 Note: Payment $0.00 NEW BALANCE S76.00 Thank you for choosing Animal Dermatology Clinic to care for your pet's dermatology needs. Your confidence is appreciated. if you need to cancel or reschedule your appointment, kindly give 24 hours notice. Pending Reminders: Wazir: 5/26/2012: Recheck Exam 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)) 11/28/11 8626 animal services Wazir $76.00 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 Animal Dermatology Clinic Indianapolis IN SUM OF 3901 E. 82nd Street Indianapolis, IN 46240 $76.00 ON ACCOUNT OF APPROPRIATION FOR Carmel Police Department PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members 1110 1 8626 I 43- 576.00 I $76.00 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 Thursday, December 01, 2011 J Chief of Police Title Cost distribution ledger classification if claim paid motor vehicle highway fund