HomeMy WebLinkAbout217612 02/26/2013 CITY OF CARMEL, INDIANA VENDOR: 354683 Page 1 of 1
ONE CIVIC SQUARE E M S A R INDIANA
CARMEL, INDIANA 46032 6745 PAYNE ROAD CHECK AMOUNT: $512.00
INDIANAPOLIS IN 46203 CHECK NUMBER: 217612
CHECK DATE: 2/26/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4350900 SI-11998 512 . 00 OTHER CONT SERVICES
EMSAR Indiana
6745 E.Payne Rd. Invoice
Indianapolis, IN 46203
(317)213-5262
(317)357-1059 Fax Customer Number Date Invoice Number
C10052 2/20/2013 SI-11998
Bill To: Ship To:
Carmel Fire Department/24 Carmel Fire Department/24
2 Civic Square 2 Civic Square
Carmel, IN 46032 Carmel, IN 46032
Attn:Accounts Payable Attn: Accounts Payable
Ship Via Terms Due Date Sales Rep Customer PO Original Order Number
-- UPS Ground Net 30 3/22/2013 103899
Item No Qty B/O Ship Description Sales Price Disc Total
PM-STRYKER 4 0 4 PREVENTIVE MAINTENANCE-STRYKER 125.00 0% 500.00
EMS
MILEAGE-STIR 24 0 24 MILEAGE-S"IRYKER EMS 0.50 0% 12.00
EMS
Total Item Count: 2 Total Items Shipped: 28
Subtotal: 512.00
Freight: 0.00
Tax: 0.00
Total: 512.00
Amount Due: 512.00
Page 1
Irescribed by State Board of Accounts City Form No.201(Rev.1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
\n invoice or bill to be properly itemized must show: kind of service,where performed, dates service rendered, by
vhom, 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))
SI-11998 Cot PM $512.00
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.
ALLOWED 20
EMSAR Indiana
IN SUM OF $
6745 Payne Road
Indianapolis, IN 46203
$512.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. j ACCT#/TITLE AMOUNT Board Members
1120 I SI-11998 I 43-509.00 I $512.00 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
FEB 2 5 2013
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund