HomeMy WebLinkAbout214697 11/20/2012 CITY OF CARMEL, INDIANA VENDOR: 163730 Page 1 of 1
ONE CIVIC SQUARE INST FOR PUBLIC SAFETY PERSONNE LI
CARMEL, INDIANA 46032 251 E OHIO STREET SUITE 1000 CHECK AMOUNT: $360.00
INDIANAPOLIS IN 46204 CHECK NUMBER: 214697
CHECK DATE: 11/20/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4341999 25481 2012PSY1103 360 . 00 EVALUATIONS
Institute for Public Safety Personnel, Inc. Invoice
251 East Ohio Street, Suite 1000
Indianapolis, IN 46204 DATE INVOICE#
11/1/2012 2012psyll03
BILL TO
Carmel Police Department
3 Civic Square
Carmel, IN 46032
DESCRIPTION QUANTITY RATE AMOUNT
Applicant psychological evaluation for Gossett, 1 360.00 360.00
Lucas
Make checks payable to: Total
$360.00
Insititute for Public Safety Personnel, Inc
Phone# Fax# E-mail
317-687-8910 317-687-9490 jeff @ipsp.net
INDIANA RETAIL TAX EXEMPT PAGE
ci CERTIFICATE NO.003120155 002 0� o Jl Carmel PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 26461
35-60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,A/P
CARMEL, INDIANA 46032-2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
FORM APPROVED BY STATE:BOARD OF ACCOUNTS FOR CITY OF CARMEL- 1997
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
MOP-0`12
Institute for Public 82tety Personnel, Inc. Carmel Police Department
VENDOR SHIP 3 Chic Square
261 East Ohle Gtrvett, Suite iOM TO Cwmel, IN 46032
Indianapolis, 114 46204 (317)671
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 43419.19
9 -.Each psychological evaluations $360.00_ $360.00
Sub Total: $360.00
° p
. �yl. $�•p S � 9 ,aFq�
d
Lucas Gossett
Send Invoice To. �,
Carmel Felice Department
Attn: Teresa Anderson
3 Civic Square
Gomel, IN 46032- PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
Cannel Felice Dept. t PAYMENT X66.Go
A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
/ NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
SHIP REPAID.
THIS APPROPRIAT.IONSUFFICIENT TO PAY FOR THE ABOVE ORDER.
•
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL v
SHIPPING LABELS. �� lane
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
4 CLERK-TREASURER
DOCUMENT CONTROL NO. A.P.I. COPY-SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO.'---.....____..__...WARRANT
i ALLOWED 20
IN THE SUM OF$
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO#or INVOICE NO. ACCT#/TITLE AMOUNT
.DEPT# I 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.__-_.....----.,....
------------
___....-._.-.-----.----------.....__-. = _
20
........................................-.....................__...._....__........--.-....__.....-----......_.................--..........._.......--._.............--..............
Signature
.....................-...-.-.......--........._..__....................._--.................-.......................
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
VOUCHER NO. WARRANT NO.
ALLOWED 20
Institute for Public Safety Personnel, Inc.
IN SUM OF $
251 East Ohio Street, Suite 1000
Indianapolis, IN 46204
$360.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
25481 I 2012psy1103 I 43-419.99 I $360.00 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
Thursday, November 15, 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))
11/01/12 2012psy1103 psych/Gossett $360.00
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