HomeMy WebLinkAbout171002 04/16/2009 CITY OF CARMEL, INDIANA VENDOR: 362785 Page 1 of 1
t ONE CIVIC SQUARE N A E M T/P H T L S
CHECK AMOUNT: $90.00
CARMEL, INDIANA 46032 PO BOX 8536
COLUMBUS MS 39705
CHECK NUMBER: 171002
CHECK DATE: 4/16/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4357004 PH -08- 2673 -0 90.00 EXTERNAL INSTRUCT FEE
S
PHTLS Confirmation Notice Invoice
Confirmation Notice
National Course PH -08- 2673 -02 Site ID 1341PH
Sponsoring Organization Riverview Hospital
City, State or Prov., Zip, Country Noblesville, IN 46060 USA
Course Coordinator Mark Young
Address 395 Westfield RD
City, State (Prov.), Zip, Country Noblesville, IN 46060 USA
Coordinator's Phone 317- 770 -2257
Coordinator's Email DSnyder @carmel.in.gov
Start/End Dates of Course December 16, 2008 December 18, 2008
Host Facility Ivy Tech Community College
Facility Contact Person Steven Smith
Facility Phone 317- 753 -1365
Type of Course Advanced Provider
(Completed by Host Facility /Course Coordinator at close of course)
4TY Description Unit Cost SubTotal
6 Advanced Provider $15.00 $90.00
(Less Applied Payments)
TOTAL DUE $90.00
Please complete the above invoice section and return If you have NOT submitted your paperwork
with your check made payable to NAEMT/PHTLS: via the NAEMT website, send a copy to:
NAEMT NAEMT PHTLS Office
PO Box 8539 PO Box 1400
Columbus, MS 39705 Clinton, MS 39060 -1400
Invoice Sent 11/13/2008 Amount Paid Date Received Check Number
Nail. Course PH -08- 2673 -02
Transmitted via .Email
(For Office Use Only)
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))
PH -08- 2673 -02 Testing for Recruits $90.00
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.
ALLOWED 20
NAEMT /PHTLS
�1 IN SUM OF
P.O. Box 8539
Columbus, MS 39705
$90.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1120 PH 2673 02 43 570.04 $90.00 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
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund