206468 02/14/2012 CITY OF CARMEL, INDIANA VENDOR: 307600 Page 1 of 1
ONE CIVIC SQUARE TREASURER OF STATE
A CARMEL, INDIANA 46032 INDIANA STATE BUDGET AGENCY CHECK AMOUNT: $80.00
200 WEST WASHINGTON STREET SUITE 2
CHECK NUMBER: 206468
INDIANAPOLIS IN 46204
CHECK DATE: 2/14/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
210 4357000 ISDT -008 80.00 TRAINING SEMINARS
INVOICE
Indiana Department of Toxicology
550 W. 16` St.
Indianapolis, IN 46202
Invoice Number: ISDT -008
Invoice Date: February 8, 2012
Vendor: Carmel Police Department
3 Civic Square
Carmel, IN 46032
Qty Unit Item Description Unit Price Ext Price
2 ea BTR Breath Test Recert. ISDT —Jan. 2012 $40.00 $80.00
Officer Christopher T. Dunlap (Completed)
Officer John K. Govvin (Completed)
Terms: NET 30 DAYS PAY THIS AMOUNT $80.00
RETAIN THIS PORTION FOR YOUR RECORDS
RETURN THIS PORTION WITH PAYMENT
Make Checks Payable To: Invoice Number: ISDT 008
Treasurer of State Invoice Date: February 8, 2012
Vendor: Carmel Police Department
Due Date: March 8, 2012
Amount Due: $80.00
Remit To: Indiana State Budget Agency
200 West Washington Street
Room 212
Indianapolis, IN 46204
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))
02/08/12 ISDT -008 breath test recert Dunlap Govin $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
VOUCHER NO. WARRANT NO.
ALLOWED 20
Indiana State Budget Agency
IN SUM OF
200 West Washington Street, Room 212
Indianapolis, IN 46204
$80.00
ON ACCOUNT OF APPROPRIATION FOR
CPD Continuing Ed Fund
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT
Board Members
210 I ISDT -008 I 570.00 I $80.0 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, February 10, 2012
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund