176412 08/19/2009 CITY OF CARMEL, INDIANA VENDOR: 272800 Page 1 of 1
ONE CIVIC SQUARE RIVERVIEW HOSPITAL
CARMEL, INDIANA 46032 PO Box 220
CHECK AMOUNT: $65.00
NOBLESVILLE IN 46060
CHECK NUMBER: 176412
CHECK DATE: 8/19/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 800396056 65.00 OTHER EXPENSES
RIVERVIEW HOSPITAL
PO BOX 220 07/26/09 OP 0270
NOBLESVILLE, IN 46061
TURNER, DAVID L 800396056 M 48 09/05/60 07/22/09 07/22/09 FINAL
CARMEL UTILITIES, CITY OF WORK MED 306782951
ATTN: ACCOUNTS PAYABLE
9609 HAZEL DELL PARKWAY
INDIANAPOLIS, IN 46280
HANRAHAN, ELIZABETH J
DETAIL OF CURRENT CHARG
07/22/09 WORK REL HEPATITIS A VACC(AD 90632 48500882 1 65.00
800396056 07/26/09 65.00
RIVERVIEW HOSPITAL
PO BOX 220 07/26/09 OP 0270
NOBLESVILLE, IN 46061
TURNER, DAVID L 800396056 M 48 09/05/60 07/22/09 07/22/09 FINAL
CARMEL UTILITIES, CITY OF WORK MED 306782951
ATTN: ACCOUNTS PAYABLE
9609 HAZEL DELL PARKWAY
INDIANAPOLIS, IN 46280
HANRAHAN, ELIZABETH J
SUMMARY OF CHARGES 65.00
PHARMACY 65.00
SUB -TOTAL OF CHARGES 65.00
PAYMENTS /ADJUSTMENTS NONE
SUBTOTAL PAYMENTS /ADJUS NONE
BALANCE 65.00
800396056 07/26/09 65.00
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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
272800
RIVERVIEW HOSPITAL Purchase Order No.
PO BOX 220 Terms
NOBLESVILLE, IN 46061 Due Date 8/11/2009
c�
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8/11/2009 800396056 $65.00
hereby certify that the attached invoice(s), or bill(s) is (are) true and
orrect and I have audited same in accordance with IC 5- 11- 10 -1.6
131, 1
Date Officer
VOUCHER 096190 WARRANT ALLOWED
272800 IN SUM OF
RIVERVIEW HOSPITAL
PO BOX 220
NOBLESVILLE, IN 46061
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
800396056 01- 7042 -06 $65.00
Voucher Total $65.00
Cost distribution ledger classification if
claim paid under vehicle highway fund