170914 04/16/2009 CITY OF CARMEL, INDIANA VENDOR: 00350806 Page 1 of 1
I ONE CIVIC SQUARE INDIANA UNIVERSITY
CARMEL, INDIANA 46032 PO Box 66271 CHECK AMOUNT: $240.00
INDIANAPOLIS IN 46266 -6271
CHECK NUMBER: 170914
CHECK DATE: 4/16/2009
DEPARTMENT ACCOUNT PO NUM BER INVOICE NUMBER Y AMOUNT DESCRIPTION
1110 4357004 01- KJ3533809 240.00 EXTERNAL INSTRUCT FEE
4
h
INDIANA UNIVERSITY PURDUE UNIVERSITY INDIANAPOLIS
CUSTOMER NUMBER: CAR912 A99% 67CGG INVOICE NUMBER:
CUSTOMER PO NBR: 01— KJ3533809
PO DT: INVOICE DATE:
03/27/2009
PROVIDED TO: BILLED BY (DO NOT REMIT TO):
ATTN: A /P. RE: 6 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 2009 -003 FEINNUMBER 356001673
QTY UNIT ITEM DESCRIPTION UNIT PRICE EXT. PRICE
6.00 EA BTR BREATH TEST RECERT.. ISDOT 3/4 -12, 2009 40.00 240.00
JOSEPH E. BICKEL
ANNA G. FLAMING
ROBERT HARRIS
RYAN D. JELLISON
RICHARD A. LOVITT
KARI E. WHITE_
TERMS: NET 30 DAYS PAYjTHIS AMOUNT 240.00
3
i
RETAIi1' TFIIS •PORTIa11'•F.OR.YOURRECOIZDS
N,17(1T("V 7) T IT' L' r) 4 /'Jnna
�Xjcrib84;,�y State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
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.
PO Box 66271
Terms
Indpls, IN 46266 6271
Date Due
Invoice invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
3/27/09 01- KJ35338 9 payment for breath test recertification 240.00
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.
X
ALLOWED 20
Indiana University IN SUM OF
PO Box 66271
Indpls, IN 46266 -6271
240.00
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
1110 1 x.73533809 570 04 240.00 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 6, 2009
a �A�
Si re
Chiey of olice
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund