The URL can be used to link to this page

Home My WebLink About207583 03/26/2012 CITY OF CARMEL, INDIANA VENDOR: 00350364 Page 1 of 1 0 ONE CIVIC SQUARE PUBLIC SAFETY MEDICAL SERVICES CHECK AMOUNT: $831.59 CARMEL, INDIANA 46032 324 E NEW YORK ST SUITE 300 INDIANAPOLIS IN 46204 CHECK NUMBER: 207583 ,ow CHECK DATE: 3/2612012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1081 4340700 17385 65.00 MEDICAL FEES 1110 4340701 17386 128.40 MEDICAL EXAM FEES 1081 4340700 17446 65.00 MEDICAL FEES 1110 4340701 17447 573.19 MEDICAL EXAM FEES INVOICE 0 Public Safety Medical Services 324 E. New York Street E Suite 300 Indianapolis, IN 46204 O Carmel Police Department 1 CARMEPD Terms 3 Civic Square Carmel, IN 46032 Invoice Date 0310912012 m Invoice 00 -17386 Date Employee Description Amount Balance Due 03/02/12 Milier Michael G. Quantiferon Tb (Blood) $52.28 $52.28 CMP (Comp Metabolic Panel $20.01 $20.01 CBC (Comp Blood Count 18.12 $18.12 Lipid Panel Blood 21.26 $21.26 Veni uncture $3.14 3.14 HIV 1 2 Blood 1159 13.59 Total Charges $128.40 Total Payments Balance Due $0.00 $128.40 Please write invoice number on payment check. Balance due 15 days from Our Federal Employer Identification Number is 35- 2079797 1Dvoice date INVOICE Public Safety Medical Services 324 E. New York Street E Suite 300 d M Indianapolis, IN 46204 G Carmel Pofice Department 1 CARMEPD t 3 Civic Square Terms Carmel, IN 46032 Invoice Date 03/15/2012 Invoice 00 -17447 Date Employee Description Amount. Balance Due 03/05/12 Collins Willie H. Quantiferon Tb Blood $52.28 $52.28 CMP (Comp Metabolic Panel 20.01 $20.01 CBC (Comp Blood Count 18.12 $18.1 2 Lipid Panel Blood 21.26 $21.26 Veni uncture $3.14 $3.141 HIV 1 2 Blood 13.59 113.59 PSA Prostate 5 ecfic A Blood 36.59 $36.59 Robbins Todd E. Quantiferon Tb Blood 52.28 $52.28 CMP (Comp Metabolic Panel 20.01 $20.01 CBC Com Blood Count 18.12 $18.1 2 Lipid I I 21 Veni uncture $3.14 $3.14 Strong, David C. CMP (Comp Metabolic Panel 20.01 $20.01 CBC (Comp Blood Count 18.12 $18.12 Lipid Panel Blood 21.26 21.26 Veni uncture $3.14 $3,14 HIV 1 2 Blood 13.59 $13.59 PSA Prostate Specific A Blood 36.59 $36.59 Quantiferon Tb (Bloodl $52.28 $52.28 Meg man Chad R. Quantiferon Tb Blood 52.28 52.28 CMP (Comp Metabolic Panel $20.01 20.01 CBC Com Blood Count 18.12 $18.1 2 .L ijpj PZnel (Blood) $21.26 Veni uncture $3.14 $3.14 HIV 1 2 Blood $13.59 $13.59 Total Charges $573.19 Total Payments Balance Due $0.00 $573.19 Please write invoice number on payment check. Our Federal Employer Identification Number is 35- 2079797 _Balance.due 15 days-from---- Invoice date VOUCHER NO. WARRANT NO. ALLOWED 20 Public Safety Medical Services IN SUM OF 324 E. New York Street, Suite 300 Indianapolis, IN 46204 $701.59 ON ACCOUNT OF APPROPRIATION FOR Carmel Police Department PO# Dept. INVOICE NO_ ACCT /TITLE AMOUNT Board Members 1110 17386 43- 407.01 $128.40 I hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and that the 1110 17447 43- 407.01 $573.19 materials or services itemized thereon for which charge is made were ordered and received except Thursday, March 22, 2012 Chief of Police Title Cost distribution ledger classification if claim paid motor vehicle highway fund 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)) 03/09/12 17386 officer physicals $128.40 03/15/12 17447 officer physicals $573.19 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 INVOICE 0 Public Safety Medical Services 324 E. New York Street E Suite 300 it Indianapolis, IN 46204 o Carmel Clay Parks Recreation CARMELPARK Terms 1411 E 116th Street Carmel, IN 46032 Invoice Date 03I0912012 Invoice 00 -17385 Date Employee Description Amount Balance Due 03/02/12 Strong, Gail C. He atilis B Vaccination #1 $65.00 $65.00 Iniection Fee $0.00 0.00 Totaf Charges $65.00 Total Payments Balance Due $0.00 $65.00 Please write invoice number on payment check. Balance ,anc 45 days fi om Our Federal Employer Identification Number is 35- 2079797 Invoice date P u rch ase G �r P.O. `�J P or F G.L. OVOO Budget P.e� MAR 12 7�1� Line Descr Purchaser 3 t 3 I z Approval Date INVOICE 0 Public Safety Medical Services 324 E. New York Street .E Suite 300 W Indianapolis, IN 46204 Carmel Clay Parks Recreation l CARMELPARK 1411E 116th Street Terms Carmel, IN 46032 Invoice Date 0311512012 m Invoice 00 -17446 Date Employee Description Amount Balance Due 03/07/12 Simpson, Brea J. He atitis B Vaccination #1 $65.00 $65.O 0 Injection Fee 0.00 $0.00 Total Charges $65.00 Total Payments Balance Due $0 -00 $65.00 Please write invoice number on payment check. Our Federal Employer Identification Number is 35- 2079797 Balance due 15 days from Invoice date pesrription r` pp �q,� �Q P.O.# PorF 1! LEE V t~. L. u 1 `f 3 7 MA 16 2012 �z�rtr t cr e I�es �isreh�ser Il Y j i L BY �hi,'t ;UU,ai Date ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice of bill to be properly itemized must show; kind of service, where performed, dates service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee Purchase Order No. 00350364 Public Safety Medical Services Terms 324 E. New York Street, Ste 300 Indianapolis, IN 46204 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO Amount 3/9112 17385 Medical fees 65.00 3115112 17446 IMedical fees 65.00 Total 130.00 1 hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and I have audited same in accordance with IC 5- 11- 10 -1.6 20_ Clerk Treasurer Voucher No. Warrant No. 00350364 Public Safety Medical Services Allowed 20 324 E. New York Street, Ste 300 Indianapolis, IN 46204 In Sum of$ 130.00 ON ACCOUNT OF APPROPRIATION FOR 108 ESE PC# or Board Members Dept INVOICE NO. ACCT #[TITLE AMOUNT 1081 -99 17385 4340700 65.00 1 hereby certify that the attached invoice(s), or 1081 -99 17446 4340700 65.00 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 22 -Mar 2012 Signature 130.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund