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Home My WebLink About172000 04/29/2009 CITY OF CARMEL, INDIANA VENDOR: 00350364 Page 1 of 1 b ONE CIVIC SQUARE PUBLIC SAFETY MEDICAL SERVICES CHECK AMOUNT: $897.00 CARMEL, INDIANA 46032 324 E NEW YORK ST SUITE 300 INDJANAPOLIS IN 46204 CHECK NUMBER: 172000 CHECK DATE: 4129/2009 DEPARTMENT T ACC OUNT PO NUMBE INVOICE NUMBER AMOUNT DESCRIPTI 1120 43.40702 T 240.00 SHOTS INOCULATIONS 1115 4350900 10945 80.00 OTHER CONT SERVICES 1110 4340701 10946 577.00 MEDICAL EXAM FEES E INVOICE r Public Safety Medical Services 324 E. New York Street E Suite 300 jr Indianapolis, IN 46204 Carmel Clay Communications I CARMCOM 31 First Avenue NW Terms Carmel, IN 46032 Invoice Date 04/22/2009 Invoice 00 -10945 Date Employee Description Amount Balance Due 04/17/09 Southeriand Nicholas R. Vision Titmus $15.00 $15.00 Audiomet W /Discrimination $65.00 $65.0 0 Total Charges $80.00` Total Payments Balance Due $0.00 $80.00 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 E. New York Street, Ste 300 Indianapolis, In 46204 $80.00 ON ACCOUNT OF APPROPRIATION FOR Carmel Clay Communications PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members 1115 00 -10945 43- 509.00 $80.00 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 Friday, April 24, 2009 Director 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)) 04/22/09 I 00 -10945 I I $80.00 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 INVOICE 0 Public Safety Medical Services 324 E. New York Street �E Suite 300 4) 0: Indianapolis, IN 46204 0 Carmel Fire Department 1 CARMEFD 2 Civic Square Terms Carmel, IN 45032 Invoice Date 04115!2009 Invoice 00 -10909 Date Employee Description Amount Balance Due 04109/09 Ray. Lucas M. Hepatitis B Vaccination #3 $70.00 $70.00 In ection Fee $10.00 $10.00 Watts. Trent E. Hepatitis B Vaccination #3 $70.00 $70.00 In ection Fee $10.00 $10.0 0 Woodburn. Scott E. Hepatitis B Vaccination #3 $70.00 $70.00 In ection Fee $10.0o $10.0 0 Total Charges g $240.00 Total Payments Balance Due $0.00 $240.00 Please write invoice number on payment check. Our Federal Employer Identification Number is 35- 2079797 Balance due 15 days from invoice date VOUCHER NO. WARRANT NO. ALLOWED 20 Public Safety Medical Services IN SUM OF 324 East New York Street, Ste. 300 Indianapolis, IN 46204 $240.00 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members 1120 10909 43- 407.02 $240.00 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 APR 2 7 2009 Fire Chief 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)) 10909 $240.00 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 Public Safety Medical Services w 324 E. New York Street E Suite 300 tY Indianapolis, IN 46204 0 Carmel Police Department I CARMEPD 3 Civic Square Terms Carmel, IN 46032 Invoice Date 04122/2009 m Invoice 00- 10946 Date Employee Description Amount Balance Due 04/17/09 Dietz Aaron K. CMP $16.00 $16.00 CBC W /Dill And Plat $13.00 $13.0 0 Lipid Panel $16.00 $16.0 0 Veni uncture Fee $3.00 $3,00 HIV 1 2 $13.00 $13.00 Quantiferon Tb Gold $50.00 $50.0 0 Frost Dwight D. CMP $16.00 $16.00 CBC W /DiffAnd Plat 113,00 $13.0 0 Li id Panel $16.00 $16.0 0 Veni uncture Fee S3.00 $3.00 HIV 1 2 $13 1 Quantiferon Tb Gold $50.00 $50.00 Harting, Charles V. CMP $16.00 $16.00 CBC W /Dill And Plat $13,00 $13.00 Lipid Panel $16.00 16.00 Veni uncture Fee $3.00 $3.00 Quantiferon Tb Gold $50.DO $50.00 Jent. Dann N. CMP $16.DO $16.0 0 CBC W /Diff And Plat $13.00 $13.00 Li id Panel $16.00 16.00 Veni uncture Fee $3.00 100 HIV 1 2 $13.00 $13.00 Quantiferon Tb Gold $50.00 $5Q-00 Pelzer, Robert S. CMP $16.00 $16.00 CBC WIDiff And Plat $13.00 $13.00 Lipid Panel $16.00 $16.00 Veni uncture Fee $3.00 $3.00 HIV 1 2 $13.00 $13.0 0 PSA $35.00 $35.0 0 Quantiferon Tb Gold $50.00 $50.00 Total Charges $577.00 77 TotaL.Payments Balance 'Due $0;00 $577:00 Please write invoice number on payment check. Our Federal Employer Identification Number is 35- 2079797 Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995) to 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 Safety Medical Services Purchase Order No. 32.4 E. New York Street, Suite 300 Terms Indianapoils, IN 46204 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 22 1Q946 paymelt for officer physicals 577.00 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 Public Safety Medical Services IN SUM OF 324 E. New York Street, Suite 300 Indianapolis, IN 46204 577.00 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 M0 .10966 07--01 577.00 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 24 2009 Signature Chief of Police Cost distribution ledger classification if Title claim paid motor vehicle highway fund