224615 09/25/2013 "yF CITY OF CARMEL, INDIANA VENDOR: 236175 Page 1 of 1
i ONE CIVIC SQUARE PARKSIDE ANIMAL HOSPITAL
CARMEL, INDIANA 46032 12962 PUBLISHERS DRIVE CHECK AMOUNT: $988.00
FISHERS IN 46038 CHECK NUMBER: 224615
CHECK DATE: 9125/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4357600 25412 193760 988 . 00 DOG FOOD
PARKSIDE ANIMAL HOSPITAL Account: 32
12962 Publishers Drive Invoice: 19376 , �_
Fishers, IN 46038 Date: 09/06/2013 '
(317) 849-1440 Time: 2:47 PM
Page: 1
f
Carmel Police De Patient: SAKA Age: 6
i 3 Civic Square Species: Canine Sex: ML
Carmel IN 46032 Breed: Hungarian Shepherd Tag: 91018
Color: Black&Tan Weight: 75.901
Doctor: Mike Havens, D.V.M.
Phone (317)571-2500 (317)571-2512
Date Service/Item Qty Price Amount
09/06/2013 1.00 0.00 0.00
09/06/2013 lams K9 Lg Breed Adult 38.5# 26.00 38.00 988.00
Tax 0.00
Net Invoice 988.00;
e
f
INDIANA RETAIL TAX EXEMPT PAGE
City ® 11 C arm( l CERTIFICATE NO.003120155 002 0 Jl \� �L x PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT
35-60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,A/P
CARMEL, INDIANA 46032-2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL- 1997
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
Parkaide Animal Hospital Carmel Police Department
VENDOR SHIP Civic Square
TO
12452 Publishers Drive Carmel, IN 46032
Fishers, IN 46M (3`17)571-2ffig
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 43-676.00
26 Each dog food $36.92 $960.00
Saab Total: $960.00
�-
Send Invoice To:
P�
Carmel Police Department
Attn;Tomse Anderson
3 Civic Square
Carmel, IN 4 PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
Carmel Police Dept. - PAYMENT $9w.00
A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
l NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
l VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERIJF y THAT THERE IS eN.UNOBLIGATED BALANCE IN
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
•SHIP REPAID.
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS. y,
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE {] hlof o1 @ Police
Poli
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. V
2 4 1 2 CLERK-TREASURER
DOCUMENT CONTROL NO. A.P.V. COPY-SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO. WARRANT NO.
ALLOWED 20
Parkside Animal Hospital
IN SUM OF $
12962 Publishers Drive
Fishers, IN 46038
$988.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
25412 I 193760 I 43-576.00 I $988.00 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
Thursday, September 19, 2013
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
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))
09/06/13 193760 dog food $988.00
I 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