211076 07/17/2012 ".E CITY OF CARMEL, INDIANA VENDOR: 307600 Page 1 of 1
ONE CIVIC SQUARE TREASURER OF STATE
CARMEL, INDIANA 46032 INDIANA STATE BUDGET AGENCY CHECK AMOUNT: $160.00
? 200 WEST WASHINGTON STREET SUITE 2
CHECK NUMBER: 211076
INDIANAPOLIS IN 46204
CHECK DATE: 7/17/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
210 4357000 ISDT-872 40 . 00 TRAINING SEMINARS
210 4357000 ISDT-873 40 . 00 TRAINING SEMINARS
210 4357000 ISDT-874 40 . 00 TRAINING SEMINARS
210 4357000 ISDT-875 40 . 00 TRAINING SEMINARS
INVOICE
Indiana Department of Toxicology
550 W. 16th St.
Indianapolis, IN 46202
Invoice Number: ISDT-872
Invoice Date: July 3, 2012
Vendor: Carmel Police Dept.
3 Civic Square
Carmel, IN 46032
Qty Unit Item Description Unit Price Ext Price
1 ea BTR Breath Test Recert. ISDT—June 2012 $40.00 $40.00
Dawson, Gregory F. PASSED
Terms: NET 30 DAYS PAY THIS AMOUNT $40.00
RETAIN THIS PORTION FOR YOUR RECORDS
----------------------------------------------------------------------------------------------------------------------------------
RETURN THIS PORTION WITH PAYMENT
Make Checks Payable To: Invoice Number: ISDT-872
Treasurer of State Invoice Date: July 3, 2012
Vendor: Carmel Police Dept.
Due Date: August 3, 2012
Amount Due: $40.00
Remit To: Indiana State Budget Agency
200 West Washington Street
Room 212
Indianapolis, IN 46204
INVOICE
Indiana Department of Toxicology
550 W. 16t'St.
Indianapolis, IN 46202
Invoice Number: ISDT-873
Invoice Date: July 3, 2012
Vendor: Carmel Police Dept.
3 Civic Square
Carmel, IN 46032
Qty Unit Item Description Unit Price Ext Price
1 ea BTR Breath Test Recert. ISDT-June 2012 $40.00 $40.00
Gilbert, William J. PASSED
Terms: NET 30 DAYS PAY THIS AMOUNT $40.00
RETAIN THIS PORTION FOR YOUR RECORDS
----------------------------------------------------------------------------------------------------------------------------------
RETURN THIS PORTION WITH PAYMENT
Make Checks Payable To: Invoice Number: ISDT-873
Treasurer of State Invoice Date: July 3, 2012
Vendor: Carmel Police Dept.
Due Date: August 3, 2012
Amount Due: $40.00 - -
Remit To: Indiana State Budget Agency
200 West Washington Street
Room 212
Indianapolis, IN 46204
INVOICE
Indiana Department of Toxicology
550 W. 16`h St.
Indianapolis, IN 46202
Invoice Number: ISDT-874
Invoice Date: July 3, 2012
Vendor: Carmel Police Dept.
3 Civic Square
Carmel, IN 46032
Qty Unit Item Description Unit Price Ext Price
1 ea BTR Breath Test Recert. ISDT—June 2012 $40.00 $40.00
Kinyon, David M. PASSED
Terms: NET 30 DAYS PAY THIS AMOUNT $40.00
RETAIN THIS PORTION FOR YOUR RECORDS
----------------------------------------------------------------------------------------------------------------------------------
RETURN THIS PORTION WITH PAYMENT
Make Checks Payable To: Invoice Number: ISDT-874
Treasurer of State Invoice Date: July 3, 2012
Vendor: Carmel Police Dept.
Due Date: August 3, 2012
Amount Due: $40.00
Remit To: Indiana State Budget Agency
200 West Washington Street
Room 212
Indianapolis, IN 46204
INVOICE
Indiana Department of Toxicology
550 W. 16th St.
Indianapolis, IN 46202
Invoice Number: ISDT-875
Invoice Date: July 3, 2012
Vendor: Carmel Police Dept.
3 Civic Square
Carmel, IN 46032
Qty Unit Item Description Unit Price Ext Price
1 ea BTR Breath Test Recert. ISDT—June 2012 $40.00 $40.00
Tilson,Travis C. PASSED
Terms: NET 30 DAYS PAY THIS AMOUNT $40.00
RETAIN THIS PORTION FOR YOUR RECORDS
----------------------------------------------------------------------------------------------------------------------------------
RETURN THIS PORTION WITH PAYMENT
Make Checks Payable To: Invoice Number: ISDT-875
Treasurer of State Invoice Date: July 3, 2012
Vendor: Carmel Police Dept.
Due Date: August 3, 2012
Amount Due: $40.00
Remit To: Indiana State Budget Agency
200 West Washington Street
Room 212
Indianapolis, IN 46204
VOUCHER NO. WARRANT NO.
ALLOWED 20
jj)cLana State Budget Agency_ �� p
IN SUM OF$
200 West Washington Street, Room 212
Indianapolis, IN 46204
$160.00
ON ACCOUNT OF APPROPRIATION FOR
CPD Continuing Ed Fund
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT, Board Members
210 ISDT-875 -570.00 $40.00 I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
210 ISDT-874 -570.00 $40.00
materials or services itemized thereon for
210 ISDT-873 -570.00 $40.00 which charge is made were ordered and
210 ISDT-872 -570.00 $40.00 received except
Wednesday, July 11, 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))
07/03/12 ISDT-875 breath test recert/Tilson $40.00
07/03/12 ISDT-874 breath test recert/Kinyon $40.00
07/03/12 ISDT-873 breath test recert/Gilbert $40.00
07/03/12 ISDT-872 breath test recert/Dawson $40.00
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