227072 12/11/2013 CITY OF CARMEL, INDIANA VENDOR: 236175 Page 1 of 1
ONE CIVIC SQUARE PARKSIDE ANIMAL HOSPITAL
CARMEL, INDIANA 46032 12962 PUBLISHERS DRIVE CHECK AMOUNT: $1,116.24
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FISHERS IN 46038 CHECK NUMBER: 227072
CHECK DATE: 12/11/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4357600 197670 33 . 82 ANIMAL SERVICES
1110 4357600 199194 34 . 43 ANIMAL SERVICES
1110 4357600 199373 55 . 96 ANIMAL SERVICES
1110 4357600 31386 199892 992 . 03 DOG FOOD
I
PARKSIDE ANIMAL HOSPITAL Account: 322
12962 Publishers Drive Invoice: 197670
Fishers, IN 46038 Date: 11/01/2013
(317) 849-1440 Time: 2:34 PM
Page: 1
Carmel Police De Patient: KASEY Age: 9
3 Civic Square Species: Canine Sex: FS
Carmel IN 46032 Breed: Dutch Sheperd Tag: 90785
Color: Black Brindle Weight: 44.50 i
Doctor: Mike Havens, D.V.M.
Phone: (317)571-2500 (317)571-2512
Date - Service/Item Qty Price Amount
11/01/2013 Soloxine .5 Mg Tabs 180.00 0.25 45.10
= Discount -11.28
3
i Tax 0.00
Net Invoice 33.82'
f ,
PARKSIDE ANIMAL HOSPITAL Account: 322
12962 Publishers Drive Invoice: 199373
Fishers, IN 46038 Date: 11/26/2013
(317) 849-1440 Time: 11:53 AM
Page: 1
Carmel Police De Patient: KASEY Age: 9
3 Civic Square Species: Canine Sex: FS :1
Carmel IN 46032 Breed: Dutch Sheperd Tag: 90785
Color: Black Brindle Weight: 44.50 E
i Doctor: Mike Havens, D.V.M.
Phone: (317)571-2500 (317)571-2512
Date Service/Item Qty Price Amounte
11/26/2013 lams K9 Intestinal 30# 1.00 74.61 74.61
Discount -18.65
f
Tax 0.00
Net Invoice 55.96
i
PARKSIDE ANIMAL HOSPITAL Account: 322
12962 Publishers Drive Invoice: 199194
Fishers, IN 46038 Date: 11/23/2013
(317) 849-1440 Time: 8:08 AM
Page: 1
Carmel Police De Patient: KASEY Age: 9
3 Civic Square Species: Canine Sex: FS
' Carmel IN 46032 Breed: Dutch Sheperd Tag: 90785'
Color: Black Brindle Weight: 44.50
Doctor: Craig Johnson, D.V.M.
! Phone: (317)571-2500 (317)571-2512
Date Service/Item Qty Price Amount
11/23/2013 lams K9 Intestinal 15# 1.00 45.91 45.91
Discount -11.48
j Tax 0.00
Net Invoice 34.43
PARKSIDE ANIMAL HOSPITAL Account: 322
12962 Publishers Drive |nvnios: 1$9892
Fishers, |m48038 Date: 12/06/2013
(317) 84A-1440 ' TI me: 4:07 PM
: 1
_-____''_-- -__'_-_
Carmel Police Do Patient: w)\SEY Age:
3 Civic Square Species: Canine Sw�c FS
Cmnnm/ IN 46032 Breed: DutchShepend Tam:
Cm|pc Q|mmk Brindle VVm|@Mt 44.50
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Doctor: Mike Havens, D.V.M.
( Phone: (317)571'2580 (317)571'2512 }
.............. _ ................... _-_ '_........'.................. __--_ ........... .......'--_'__'' ' ___ - _ /
| ' '- - ' -' ---------------'- --------~----' |
/ ' .......... .... ..................___'---' __.__...........`............-'____-�' ..................
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Service/Item oty Price Amount
lams K9 Intestinal 3D# 15.00 D 77.14 1157.10
Oiscoynt -289.28
Tax 0.00
Net Invoice 867.82
Previous Balance 124.21
Payment 0.00
Balance Due 992.03
__ ----_- ..............-...................... ......... . __-............. '-__................. ........-..._.........
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Reminders: Nov. 9, 2018 Rabies Vaccine 3 Year
Apr124. 2014 T4, Post Pill
Apd 22. 2014 TdYaxha4O1-60# 6 Months
OcL 24.2014 Annual VVwUnma Physical Exam
Oct. 24,2014 Dist-A2p'9mmoAnnum|
Oct. 24. 2014 LmpUomp|nnm|n vaccine annual
Oct. 24. 2D14 l3mrdeteUaVmccAnnual
Oct. 24. 2O14 Heartw ,nnTewtOcou|t
Oct, 24. 2014 Fecal Exam Annual
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VVe strive 0mpnovde quality and compassionate care with e personal touch!
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(�° Carmel INDIANA RETAIL TAX EXEMPT PAGE
City ®'Jllr CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT
35-60000972 3 sm
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,A/P
CARMEL, INDIANA 46032-2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL- 1997 SHIPPING LABELS AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
92ZM13
Pmrholdo AnImml Hospital CamGl Pollea DGp irtmon4
VENDOR SHIP 3 Civic squr>m
TO
i2M Puhllahom Ddvo Cu ffiGl, IN 4
FIShon, IN 4M 317)671-2574
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 43-676.00
9 Each dog foods $992.03 $002.03
Sub Total: $992.03
Send Invoice To:
Ca anon PollcG D®pa dmGnt
Attn: pat Young
3 Civic Squaw
Ca rmol IN 4m- PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
Carmel folic@ Dept. , �" PAYMENT 42.03
• A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THATJ� RE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATIO UFFICIENT TO PAY FOR THE ABOVE ORDER.
SHIP REPAID.
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. v
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS.
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE Ehz of Pallet!)
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK-TREASURER
DOCUMENT CONTROL NO. 3138'6 A.P.V. COPY-SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO. WARRANT NO.
ALLOWED 20
�— IN THE SUM OF$
ON ACCOUNT OF APPROPRIATION FOR
s ,
Board Members
PO#or INVOICE NO. ACCT#/TITLE AMOUNT
DEPT.# I 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
20
Signature ;
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))
11/01/13 197670 animal services/Kasey $33.82
11/23/13 199194 animal services/Kasey $34.43
11/26/13 199373 animal services/Kasey $55.96
12/05/13 199892 dog food $992.03
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
Parkside Animal Hospital
IN SUM OF $
12962 Publishers Drive
Fishers, IN 46038
$1,116.24
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1110 197670 43-576.00 $33.82 I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
1110 199194 43-576.00 $34.43
materials or services itemized thereon for
1110 199373 43-576.00 $55.96 which charge is made were ordered and
31386 199892 43-576.00 $992.03 received except
Friday, December 06, 2013
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund