215485 12/12/2012 CITY OF CARMEL, INDIANA VENDOR: 307600 Page 1 of 1
ONE CIVIC SQUARE TREASURER OF STATE CHECK AMOUNT: $680.00
i4�•io CARMEL, INDIANA 46032 INDIANA STATE BUDGET AGENCY
200 WEST WASHINGTON STREET SUITE 2 CHECK NUMBER: 215485
INDIANAPOLIS IN 46204
CHECK DATE: 12/12/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
210 4357000 ISDT-1719 40 . 00 TRAINING SEMINARS
210 4357000 ISDT-1720 40 . 00 TRAINING SEMINARS
210 4357000 ISDT-1885 300 . 00 TRAINING SEMINARS
210 4357000 ISDT-1886 300 . 00 TRAINING SEMINARS
INVOICE
Indiana Department of Toxicology
550 W. 16`h St.
Indianapolis, IN 46202
Invoice Number: ISDT-1885
Invoice Date: December 5, 2012
Vendor: Carmel Police Dept.
3 Civic Square _
Carmel,IN 46032 - - - - - - - --- — --P
Qty Unit Item Description Unit Price Ext Price
1 ea BTS O'Brian, Mary Kathalyn $300.00 $300.00
Terms: NET 30 DAYS PAY THIS AMOUNT $300.00
RETAIN THIS PORTION FOR YOUR RECORDS
INVOICE
Indiana Department of Toxicology
550 W. 16"St.
Indianapolis, IN 46202
Invoice Number: ISDT-1886
Invoice Date: December 5, 2012
Vendor: Carmel Police Dept.
3 Civic Square
Carmel, IN 46032
Qty Unit Item Description Unit Price Ext Price
1 ea BTS Zellers,T. Andrew $300.00 $300.00
Terms: NET 30 DAYS PAY THIS AMOUNT $300.00
RETAIN THIS PORTION FOR YOUR RECORDS
INVOICE
Indiana Department of Toxicology
550 W. 16"St.
Indianapolis, IN 46202
Invoice Number: ISDT-1720
Invoice Date: December 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 Recertification $40.00 $40.00
Malloy, Katherine E.
INVOICE
Indiana Department of Toxicology
550 W. 16th St.
Indianapolis, IN 46202
Invoice Number: ISDT-1719
Invoice Date: December 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 Recertification $40.00 $40.00
Amos, Chad B.
VOUCHER NO. WARRANT NO.
ALLOWED 20
Indiana State Budget Agency
IN SUM OF $
200 W. Washington Street, Room 212
Indianapolis, IN 46204
$680.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1110 ISDT-1720 43-430.02 $40.00 I hereby certify that the attached invoice(s), or
bill(s) is (are)true and correct and that the
1110 ISDT-1719 43-430.02 $40.00
materials or services itemized thereon for
1110 ISDT-1886 43-430.02 $300.00 which charge is made were ordered and
1110 ISDT-1885 43-430.02 $300.00 received except
Friday, December 07, 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))
12/03/12 ISDT-1720 breath test recert-Malloy $40.00
12/03/12 ISDT-1719 breath test recert-Amos $40.00
12/05/12 ISDT-1886 breath test cert-A.Zellers $300.00
12/05/12 ISDT-1885 breath test cert-O'Brian $300.00
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