HomeMy WebLinkAbout180140 12/08/2009 CITY OF CARMEL, INDIANA VENDOR: 00350806 Page 1 of 1
ONE CIVIC SQUARE INDIANA UNIVERSITY
i CHECK AMOUNT: $40.00
CARMEL, INDIANA 46032 PO BOX 66271
INDIANAPOLIS IN 46266 -6271 CHECK NUMBER: 180140
CHECK DATE: 12/8/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4357004 1LB1993410 40.00 EXTERNAL INSTRUCT FEE
INDIANA UNIVERSITY PURDUE UNIVERSITY INDIANAPOLIS
CUSTOMER NUMBER: CAR912 11PZlTf067CGG INVOICE NUMBER:
CUSTOMER PO NBR: 01 LB1993410
PO DT: INVOICE DATE:
11/24/2009
i
PROVIDED TO: BILLED BY (DO NOT REMIT TO):
TTN: A /P. RE: DANIEL M. MATTHEWS INDIANA UNIVERSITY
PHARMACOLOGY TOXICOLOGY
CARMEL PD MS A401
3 CIVIC SQUARE INDIANAPOLIS IN 46202 -5120
/317 274 -7825
CARMEL IN 46032 FAX 31.7- 278 -2836
INDIANA STATE DEPT. OF TOXICOLOGY ISDT 2009 -011 FEENNUMBER 356001673
QTY UNIT ITEM DESCRIPTION UNIT PRICE EXT. PRICE
1.00 EA BTR BREATH TEST RECERT. ISDOT NOV 9 13, 09 40.00 40.00
TERMS: NET 30 DAYS PAY THIS AMOUNT 40.00
RL'TAIA'•Tlil &PORTION FOR1'OUR•RECORDS
TNVOTCE nATE 11/24/2009
PrayI.*edby State Board ofAccounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
G 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
i. Indiana University Purchase Order No.
P.O. Box 66271 Terms
Indianapolis, IN 46266 -6271 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
11/24109 ILBI-9-93410 D ayment for breath e
Total
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
V4JCHER NO. NO.
ALLOWED 20
I ndiana University
IN SUM OF
P.O. Bo x66271
Indianapolis, IN 46266 -6271
40.00
ON ACCOUNT OF APPROPRIATION FOR
cont ed fund
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
210 1LB1993410 570 40.00 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
December 3 20 09
Signature
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund