172886 05/27/2009 CITY OF CARMEL, INDIANA VENDOR: 00350806 Page 1 of 1
ONE CIVIC SQUARE INDIANA UNIVERSITY CHECK AMOUNT: $280.00
CARMEL INDIANA 46032
Po sox 66271
ti oN .o. INDIANAPOLIS IN 46266 -6271 CHECK NUMBER: 172886
CHECK DATE: 5/27/2009
DEPARTME A CCOUNT PO NUMBER INVOICE N AMOUNT DE SCRIPTION
210 4357000 1ZJ0527809 280.00 TRAINING SEMINARS
�s
INDIANA UNIVERSITY PURDUE UNIVERSITY INDIANAPOLIS
i
CUSTOMER NUMBER: CAR912 I�d'M 67 CC, G INVOICE NUMBER:
CUSTOMER PO NBR: 01 ZJ0527809
PO DT: INVOICE DATE:
05/12/2009
PROVIDED TO: BILLED BY (DO NOT REMIT TO):
ATTN: A /P. RE: 7 ATTENDEES INDIANA UNIVERSITY
PHARMACOLOGY TOXICOLOGY
CARMEL PD MS A401
3 CIVIC SQUARE INDIANAPOLIS IN 46202 -5120
/317 -274 -7825
CARMEL IN 46032 FAX 317- 278 -2836
INDIANA STATE DEPT. OF TOXICOLOGY- BTR 2009 -004 FEINMWBER 356001673
QTY UNIT ITEM DESCRIPTION UNIT PRICE EXT. PRICE
7.00 EA BTR BREATH TEST RECER.T. ISDOT 3/30 -4/15, 09 40.00 280.00
CHARLES B. FISHER
DWIGHT D. FROST
BRYAN L. HOOD
MICHAEL L. MABIE
SCOTT PILKINGTON
MICHAEL T. RUSH
JEFFREY T. SEDBERRY
TERMS: NET 30 DAYS PAY THIS AMOUNT 280.00
RETAIN T)jIS.PORTION.FOR.YOUR RECORDS
TNVn rrF DATE 0,517211 09
Prescribe�y State Board of Accosts 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
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))
IZJ05 27809 payment for breath .:test recert for officers 280.00
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
L kdiana University IN SUM OF
P.O. Box 66271
Indianapolis, IN 46266 -6271
280.00
ON ACCOUNT OF APPROPRIATION FOR
c ont ed fund
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
210 1ZJ0527809 570 280.00 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
May 18 2009
Signature
Ch of of o
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund