222427 07/30/2013 voided CITY OF CARMEL, INDIANA VENDOR: 00350790 Page 1 of 1
ONE CIVIC SQUARE HAMILTON COUNTY HEALTH DEPARTMENT
CARMEL, INDIANA 46032 18030 FOUNDATION DRIVE :HECK AMOUNT: $33.00
NOBLESVILLE IN 46060 CHECK NUMBER: 222427
CHECK DATE: 7/30/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 8069342 33 . 00 OTHER EXPENSES
Hamilton County Health Department
18030 Foundation Drive, Suite A
r Noblesville, In 46060
Phone:(317)776-8500
- _ Fax:(317)776-8506
Health Education Course Invoice
Invoice#: 8069342
Invoice Date 7/22/2013
Customer PO:
Invoice To Information Educational Course Information
Contact: Blaine Mallaber Course Title: Heartsaver CPR/AED&Adult FA
Bill to: Course Date: 7/17/2013
City Of Carmel WWTP
Location: City Of Carmel WWTP
Address: 9609 Hazel Dale Park Way
Indpls, IN 46280 Instructor: James R. Ginder,MS,EMT,PI,CHES
Cost per Student: $3.00
Billable Spaces: 11
Fee Amount: $33.00
Certification Cards will be mailed upon receipt of payment
Payment Received: CASH or Check#: Initial:
Please Make Payment To: Riverview Hospital
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Retain this portion for you records
Course
Course Date 7/1712013 Certification Cards will be mailed upon receipt of payment
Fee $33.00
Printed: 7/22/2013 08:22:10 White - Billing Contact Yellow - Hospital
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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
00350790
HAMILTON COUNTY HEALTH DEPARTMENT Purchase Order No.
18030 FOUNDATION DRIVE Terms
SUITE A Due Date 7/23/2013
NOBLESVILLE, IN 46060
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7/23/2013 8069342 $33.00
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
Date Officer
VOUCHER # 136026 WARRANT# ALLOWED
00350790 IN SUM OF $
HAMILTON COUNTY HEALTH DEPART
18030 FOUNDATION DRIVE
SUITE A
NOBLESVILLE, IN 46060
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
8069342 01-7752-05 $33.00
Voucher Total $33.00
Cost distribution ledger classification if
claim paid under vehicle highway fund