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HomeMy WebLinkAbout320350 01/04/18 CITY OF CARMEL, INDIANA VENDOR: 366244 ONE CIVIC SQUARE MEDASSURE CHECK AMOUNT: $*******240.00* CARMEL, INDIANA 46032 920 E COUNTY LINE ROAD CHECK NUMBER: 320350 t�iiox`off SUITE 102 CHECK DATE: 01/04/18 LAKEWOOD NJ 08701 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 651 5023990 W58890 240.00 OTHER EXPENSES VOUCHER NO. 177056 WARRANT NO. ALLOWED 20 Prescribed by State Board of Accounts City Form No.201(Rev 1995) Vendor # 366244 IN SUM OF$ ACCOUNTS PAYABLE VOUCHER MEDASSURE CITY OF CARMEL 920 E County Line Road An invoice or bill to be properly itemized must show: kind of service,where performed, Ste 102 dates service rendered, by whom, rates per day, number of hours, rate per hour, Lakewood, NJ 08701 numbers of units, price per unit,etc. Payee 240.00 366244 Purchase Order No. ON ACCOUNT OF APPROPRATION FOR MEDASSURE Terms Carmel Wasterwater Utility 920 E County Line Road Due Date BOARD MEMBERS Ste 102 I hereby certify that that attached invoice(s), Lakewood, NJ 08701 or bill(s)is(are)true and correct and that PO# ACCT# the materials or services itemized thereon for DATE INVOICE# Description DEPT# INVOICE# Fund# AMOUNT which charge is made were ordered and DEP-r# FUND# (or note attached invoice(s)or bill(s)) AMOUNT W58890 01-73611-08 $240.00 and received except 12/29/2017 W58890 $240.00 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 Cost distribution ledger classification if claim paid motor vehicle highway fund. 20-- Clerk-Treasurer Invoice MedAssure Date Invoice No. _ 920 E County Line Rd 11/03/2017 W 58890 -- Suite 102 MEDAssun Lakewood,NJ 08701 Terms. Due Date (732)363-7444 billing@medassureservices.com Net 30 12/02/2017 Bill To:Customer ID:(4393-8324) Ship To: Carmel Household Hazardous Waste Carmel Household Hazardous Waste 30 West Main 901 N Range Line Rd Carmel,IN 46032 Carmel,IN 46032 Tracking#:8324-11-02-2017-183709-B SIC# Tax Exempt ID# Balance Due Enclosed -- — — ----- --- $240A0 PO Number# Ship Date Ship Via 11/03/2017 MedAssure Date Description Cont.Count Weight Unit Price Amount 11/03/2017 Manifest# 8324-11-02-2017-183709-8 Flat rate for first 8 RMW cont(s). $240.00 $240.00