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
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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