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HomeMy WebLinkAbout224100 09/10/2013 CITY OF CARMEL, INDIANA VENDOR: 00350364 Page 1 of 1 ONE CIVIC SQUARE PUBLIC SAFETY MEDICAL SERVICES CARMEL, INDIANA 46032 324 E NEW YORK ST SUITE 300 CHECK AMOUNT: $37.14 INDIANAPOLIS IN 46204 CHECK NUMBER: 224100 CHECK DATE: 9/10/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1091 4340700 21103 37 . 14 MEDICAL FEES INVOICE 0 Public Safety Medical Services 324 E. New York Street Suite 300 Indianapolis, IN 46204 c. Carmel Clay Parks & Recreation/CARMELPARK Attn: Jeff Kramer Terms 1411 E. 116th Street Invoice Date 08/21/2013 m Carmel, IN 46032 Invoice# 00-21103 Date Employee Description Amount Balance.Due'. 08/13/13 Wright,Paula A. He B Titer SAb-Quantitative Blood 37.14 $37.1 4 Veni uncture $0.00 $0.00 Total Charges > $37.14 Total Payments&Balance Due-> $0.00: $37.14 Please write invoice number on payment check. Balance due 15 days from invoice Our Federal Employer Identification Number is 35-2079797 date AUG 23 2013 BY: Purchase D�;sr:ripf;^n U.i PorF 9r3VQ 70 P u!`chaser •>t. ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice of 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. 00350364 Public Safety Medical Services Terms 324 E. New York Street, Ste 300 Indianapolis, IN 46204 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO # Amount 8/21/13 21103 Medical fees $ 37.14 Total $ 37.14 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. 00350364 Public Safety Medical Services Allowed 20 324 E. New York Street, Ste 300 Indianapolis, IN 46204 In Sum of$ $ 37.14 ON ACCOUNT OF APPROPRIATION FOR 109 Monon Center PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members Dept# 1091 21103 4340700 $ 37.14 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 5-Sep 2013 Signature $ 37.14 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund