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219562 04/24/2013 CITY OF CARMEL, INDIANA VENDOR: 307600 Page 1 of 1 j. ONE CIVIC SQUARE TREASURER OF STATE 4 CARMEL, INDIANA 46032 INDIANA STATE BUDGET AGENCY CHECK AMOUNT: $280.00 ? 200 WEST WASHINGTON STREET SUITE 2 o CHECK NUMBER: 219562 INDIANAPOLIS IN 46204 CHECK DATE: 4/24/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 210 4357000 ISDT- 40 . 00 ISDT-2139 210 4357000 ISDT- 40 . 00 ISDT-2140 210 4357000 ISDT- 40 . 00 ISDT-2141 210 4357000 ISDT- 40 . 00 ISDT-2142 210 4357000 ISDT- 40 . 00 ISDT-2412 210 4357000 ISDT- 40 . 00 ISDT-2413 210 4357000 ISDT- 40 . 00 ISDT-2414 INVOICE Indiana Department of Toxicology 550 W. 16`h St. Indianapolis, IN 46202 Invoice Number: ISDT-2412 Invoice Date: April 10, 2013 Vendor: Carmel Police Department 3 Civic Square Carmel, IN 46032 Qty Unit Item Description Unit Price Ext Price 1 ea BTR Breath Test Recertification - February $40.00 $40.00 Aaron Leach 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-2412 Treasurer of State Invoice Date: April 4, 2013 Vendor: Carmel Police Department Due Date: May 6, 2013 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-2413 Invoice Date: April 10, 2013 Vendor: Carmel Police Department 3 Civic Square Carmel, IN 46032 Qty Unit Item Description Unit Price Ext Price 1 ea BTR Breath Test Recertification - February $40.00 $40.00 Joseph Bickel 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-2413 Treasurer of State Invoice Date: April 4, 2013 Vendor: Carmel Police Department Due Date: May 6, 2013 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-2414 Invoice Date: April 10, 2013 Vendor: Carmel Police Department 3 Civic Square Carmel, IN 46032 Qty Unit Item Description Unit Price Ext Price 1 ea BTR Breath Test Recertification - February $40.00 $40.00 Matthew Broadnax 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-2414 Treasurer of State Invoice Date: April 4, 2013 Vendor: Carmel Police Department Due Date: May 6, 2013 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-2139 Invoice Date: April 4, 2013 Vendor: Carmel Police 3 Civic Square Carmel, IN 46032 Qty Unit Item Description Unit Price Ext Price 1 ea BTR Breath Test Recertification -January $40.00 $40.00 Bryan Hood 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-2139 Treasurer of State Invoice Date: April 4, 2013 Vendor: Carmel Police Due Date: May 6, 2013 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-2140 Invoice Date: April 4, 2013 Vendor: Carmel Police 3 Civic Square Carmel, IN 46032 Qty Unit Item Description Unit Price Ext Price 1 ea BTR Breath Test Recertification -January $40.00 $40.00 Andrew Gerdt 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-2140 Treasurer of State Invoice Date: April 4, 2013 Vendor: Carmel Police Due Date: May 6, 2013 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"St. Indianapolis, IN 46202 Invoice Number: ISDT-2141 Invoice Date: April 4, 2013 Vendor: Carmel Police 3 Civic Square Carmel, IN 46032 Qty Unit Item Description Unit Price Ext Price 1 ea BTR Breath Test Recertification -January $40.00 $40.00 Charles Driver 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-2141 Treasurer of State Invoice Date: April 4, 2013 Vendor: Carmel Police Due Date: May 6, 2013 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"St. Indianapolis, IN 46202 Invoice Number: ISDT-2142 Invoice Date: April 4, 2013 Vendor: Carmel Police 3 Civic Square Carmel, IN 46032 Qty Unit Item Description Unit Price Ext Price 1 ea BTR Breath Test Recertification -January $40.00 $40.00 Robert Harris 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-2142 Treasurer of State Invoice Date: April 4, 2013 Vendor: Carmel Police Due Date: May 6, 2013 Amount Due: $40.00 i Remit To: Indiana State Budget Agency 200 West Washington Street Room 212 Indianapolis, IN 46204 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)) 04/04/10 ISDT-2142 breath test recert- R. Harris $40.00 04/04/13 ISDT-2141 breath test recert- Driver $40.00 04/04/13 ISDT-2140 breath test recert-Gerdt $40.00 04/04/13 ISDT-2139 breath test recert- Hood $40.00 04/10/13 ISDT-2414 breath test recert- Broadnax $40.00 04/10/13 ISDT-2413 breath test recert-J. Bickel $40.00 04/10/13 ISDT-2412 breath test recert- Leach $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 VOUCHER NO. WARRANT NO. ALLOWED 20 Indiana State Budget Agency P-6� 0(� � ' IN SUM OF $ 200 West Washington Street, Room 212 Indianapolis, IN 46204 $280.00 ON ACCOUNT OF APPROPRIATION FOR CPD Continuing Ed Fund PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members Prfor Year I hereby certify that the attached invoice(s), or 210 ISDT-2142 -570.00 $40.00 bill(s) is (are) true and correct and that the 210 ISDT-2141 -570.00 $40.00 materials or services itemized thereon for 210 ISDT-2140 -570.00 $40.00 which charge is made were ordered and 210 ISDT-2139 -570.00 $40.00 received except 210 ISDT-2414 -570.00 $40.00 210 ISDT-2413 -570.00 $40.00 210 ISDT-2412 -570.00 $40.00 /Thursday, April 18, 2013 Chief of Police Title Cost distribution ledger classification if claim paid motor vehicle highway fund