HomeMy WebLinkAbout305221 11/14/16 CITY OF CARMEL, INDIANA VENDOR: 371298
ONE CIVIC SQUARE MDX MEDICAL INC CHECK AMOUNT: $"""1,000.00'
CARMEL, INDIANA 46032 VITALS CHECK NUMBER: 305221
160 CHUBB AVE SUITE 301 CHECK DATE: 11/14/16
LYNDHURST NJ 07071
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
301 5023990 14858 1,000.00 OTHER EXPENSES
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
MDX MEDICAL INC ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
VITALS IN SUM OF$ CITY OF CARMEL
160 CH UBB AVE SUITE 301 An invoice or bill to be properly itemized must show:kind of service,where performed,dates service
LYNDHURST, NJ 07071 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
$1,000.00 Payee
ON ACCOUNT OF APPROPRIATION FOR Purchase Order#
301 Medical Fund Terms
Date Due
PO# ACCT# DATE INVOICE# DESCRIPTION
DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT
14858 50-239.90 $1,000.00 1 hereby certify that the attached invoice(s),or 11/2/16 14858 $1,000.00
301 301 301 301
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
Monday, November 07, 2016
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—
Cost
20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer
Invoice
MDx Medical, Inc. Date 11/2/2016
Vitals Invoice# 14858
160 Chubb Ave. Terms Due on Receipt
Suite 301
Lyndhurst NJ 07071 Due Date 11/2/2016
PO# INITIAL DEPOSIT
Bill To
City of Carmel
1 Civic Square
Carmel IN 46032
e- o
Initial Incentive Fund Deposit per Contract 1,000.00
Submitted To
NOV 0 7 2016
Clerk Tr- surer
We appreciate your prompt payment. Total $1,000.00
Payment by ACH Mailing Address for Checks
Silicon Valley Bank PLEASE NOTE OUR NEW ADDRESS BELOW:
3003 Tasman, Santa Clara,CA 95054 Vitals
Account Name:MDx Medical Inc. Accounts Receivable
Account#3301294052 160 Chubb Ave.
ACH ABA Routing#121140399 Suite 301
Lyndhurst, NJ 07071