HomeMy WebLinkAbout234067 6 /25/2014 CITY OF CARMEL, INDIANA VENDOR: 366244
(' ONE CIVIC SQUARE MEDASSURE CHECK AMOUNT: $M•M M M f*200.00•
CARMEL, INDIANA 46032 1013 S GIRLS SCHOOL ROAD CHECK NUMBER: 234067
INDIANAPOLIS IN 46231 CHECK DATE: 06/25/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 1828573 200.00 OTHER EXPENSES
MedAssure :`Customer Number
� �. 1013 S. Girls School Road
Indianapolis, IN 46231 000240
(317)635-8000
MED
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05/31/201 4
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BILL TO: 001828573
Carmel Household Hazardous Waste
30 West Main
Carmel, IN 46032
TERMS DUE DATE SALES REP
SERVICE DATE Net 15 Days 06/15/2014
DESCRIPTION CONT.COUNT I QTYMGHT UNIT PRICE FAMOUNT
11/30/13 Invoice#00001711 5 - .200-.00-
001
00.001 -Carmel Household Hazardous-901 N Range Line Rd
Manifest#0000193331
05/15/14 31 Gallon Mixed Waste Per Container 1 8.00 25.00 200.00
'1 20
CURRENT 30 DAYS 60 DAYS 90 DAYS OVER 90 DAYS
Invoice Amount 200.00
200.00 0.00 0.00 0.00 200.00
VOUCHER # 138240 WARRANT # ALLOWED
366244
IN SUM OF $
MEDASSURE
1013 S GIRLS SCHOOL ROAD
INDIANAPOLIS, IN 46231
i
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO* INV# ACCT# AMOUNT Audit Trail Code
1828573 01-720H-08 $200.00
Voucher Total $200.00
Cost distribution ledger classification if
claim paid under vehicle highway fund
Prescribed by State Board of Accounts City Form No.201 (Rev 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
i..
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
366244
MEDASSURE Purchase Order No.
1013 S GIRLS SCHOOL ROAD Terms
INDIANAPOLIS, IN 46231 Due Date 6/17/2014
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6/17/2014 1828573 $200.00
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
Date O 4cer