174949 07/22/2009 CITY OF CARMEL, INDIANA VENDOR: 360377 Page 1 of 1
ONE CIVIC SQUARE INSTITUTE FOR PUBLIC SAFETY PERS %ECK AMOUNT: $250.00
CARMEL, INDIANA 46032 251 E OHIO ST STE 1000
INDPLS IN 46204 CHECK NUMBER: 174949
CHECK DATE: 7/22/2009
D EPAR T MENT ACCO PO NUMBER IN VOICE NUMBE AMOUNT DESC
1120 4340701 2009PSY608 250.00 MEDICAL EXAM FEES
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Institute for Public Safety Personnel, Inc. Invoice
251 East Ohio Street, Suite 1000
Indianapolis, IN 46204 DATE INVOICE
7/8/2009 2009psy6o8
BILL TO
Carmel Fire Department
2 Civic Square
Carmel, IN 46032
DESCRIPTION QUANTITY RATE AMOUNT
Follow-up incumbent fitness for duty 1 250.00 250.00
psychological evaluation for R.K. on 4/16/2009
1
i
Make checks payable to: Total
$250.00
Insititute for Public Safety Personnel, Inc
Phone Fax E -mail
317- 687 -8910 317- 687 -9490 info @ipsp.net
Prescribed by State Board of Accounts City Form No. 20 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))
2009psy608 $250.00
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
VOUCHER NO. -WARRANT NO.
Institute for Public Safety ALLOWED 20
IN SUM OF
251 East Ohio Street, Ste. 1000
Indianapolis, IN 46204
$250.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1120 2009psy608 43- 407.01 $250.00 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
JUL 2 0 2009
n
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund