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213128 09/25/2012 CITY OF CARMEL, INDIANA VENDOR: 236175 Page 1 of 1 ONE CIVIC SQUARE PARKSIDE ANIMAL HOSPITAL f CARMEL, INDIANA 46032 12962 PUBLISHERS DRIVE CHECK AMOUNT: $178.62 ? FISHERS IN 46038 CHECK NUMBER: 213128 CHECK DATE: 9/25/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1110 4357600 169291 178 . 62 ANIMAL SERVICES PARKSIDE ANIMAL HOSPITAL Account: 322 12962 Publishers Drive Invoice: 169291 Fishers, IN 46038 Date: 09/05/2012 (317) 849-1440 Time: 6:48 AM Page: 1 Carmel Police De Patient: LEO Age: 1 3 Civic Square Species: Canine Sex: ML Carmel IN 46032 Breed: Labrador Retriever Tag: 90348 1 Color: Black Weight: 67.00 Doctor: Mike Havens, D.V.M. Phone: (317)571-2500 (317)571-2512 i Date Service/Item Qty Price Amount 09/04/2012 Annual Wellnes Physical Exam 1.00 D 45.64 45.64 09/04/2012 Dist-A2P-Parvo Annual 1.00 D 20.11 20.11 09/04/2012 Leptospirosis vaccine annual 1.00 D 25.22 25.22 09/04/2012 Leptospirosis Vaccine-4 way 1.00 0.00 0.00 1 E 09/04/2012 Bordetella Vacc Annual 1.00 D 21.08 21.08 109/04/2012 Lyme Disease Vacc Annual 1.00 D 24.91 24.91 09/04/2012 Rabies Vaccine 3 Year 1.00 D 23.91 23.91 09/04/2012 Fecal Exam Annual 1.00 D 25.81 25.81 09/04/2012 Ear Cleaning Soln 1.00 D 20.39 09/04/2012 Otomax/Malotic 15GM 1.00 D 31.11 Discount -59.56 Tax 0.00 i i Net Invoice 178.62 Previous Balance -8.99 1 Payment 0.00 Balance Due 169.63 � Reminders: June 41 2013 Heartworm Test Occult June 4, 2013 Heartgard Plus 51-100# 12mos. Sept. 4, 2013 Annual Wellnes Physical Exam Sept. 4, 2013 Dist-A2P-Parvo Annual Sept. 4, 2013 Leptospirosis vaccine annual Sept. 4, 2013 Bordetella Vacc Annual Sept. 4, 2013 Lyme Disease Vacc Annual Sept. 4, 2015 Rabies Vaccine 3 Year Sept. 4, 2013 Fecal Exam Annual Thank You [D] 25% Discount Applied We endeavor to provide quality care with a personal touch! 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)) 09/05/12 169291 animal services- Leo $178.62 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 Parkside Animal Hospital IN SUM OF $ 12962 Publishers Drive Fishers, IN 46038 $178.62 ON ACCOUNT OF APPROPRIATION FOR Carmel Police Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1110 I 169291 I 43-576.00 I $178.62 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 Wednesday, September 19, 2012 Chief of Police Title Cost distribution ledger classification if claim paid motor vehicle highway fund