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HomeMy WebLinkAbout234067 6 /25/2014 CITY OF CARMEL, INDIANA VENDOR: 366244 (' ONE CIVIC SQUARE MEDASSURE CHECK AMOUNT: $M•M M M f*200.00• CARMEL, INDIANA 46032 1013 S GIRLS SCHOOL ROAD CHECK NUMBER: 234067 INDIANAPOLIS IN 46231 CHECK DATE: 06/25/14 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 651 5023990 1828573 200.00 OTHER EXPENSES MedAssure :`Customer Number � �. 1013 S. Girls School Road Indianapolis, IN 46231 000240 (317)635-8000 MED Q SSInvoiceDate h �° 05/31/201 4 A UKE :�;SEA �v.fnNSvtUT'ut{cuR'OJR��ED:GAt,ASi�3`F�w� Invoice&�!lu�rr!$ber � ' 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