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Home My WebLink About183390 03/16/2010 CITY OF CARMEL, INDIANA VENDOR: 204038 Page 1 of 1 ONE CIVIC SQUARE MIDWEST TOXICOLOGY SVS,INC CHECK AMOUNT: $199.00 CARMEL, INDIANA 46032 603 E WASHINGTON ST SUITE 200 INDIANAPOLIS IN 46204 CHECK NUMBER: 183390 .oe o CHECK DATE: 3116/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1201 R4358800 19348 199547 55.00 TESTING FEES 1201 R4358800 19348 199698 89.00 TESTING FEES 1201 R4358800 19348 199746 55.00 TESTING FEES 1`i31}� 914idwest Toxicofogy Inv DATE INVOICE 603 East Washington Street, Suite 200, Indianapolis, IN 46204 3/3/2010 199698 BILL TO: SHIP TO: City of Carmel Names location of collection Attn: Jim Spelbring on invoices no ss 1 Civic Square Email results to Barb Lamb cc Jim Carmel, IN 46032 Still Mail results to Jim Ctz CONTROL P.O. NUMBER JOB SITE TERMS FACILITY 5528 Due on receipt 142376 ITEM CODE QTY DESCRIPTION PRICE EACH AMOUNT ND Drug Test CS 1 Non -DOT Drug Test 55.00 55.00 Collected at Community Occupational Health 02/27/10 Chad Amon ND Alcohol CS 1 Non -DOT Breath Alcohol Test 28.00 28.00 Collected at Community Occupational Health 02/27/10 Chad Amos BAT Surcharge 1 Please note that you are being charged an additional fee due to your 6.00 6.00 collection site breath alcohol charges. D z LIAR 2010 By A finance charge will be assessed on all invoices not paid in 30 days. Thank you for your business. For the purpose of client confidentiality we are no longer showing the full SSN on invoices. Total $89.00 Make Checks Payable To: MIDWEST TOXICOLOGY SERVICES, INC. For questions regarding this invoice, contact us at 317- 262 -2200 or fax us at 317 262 -2221. Be sure to visit our website at wwtt�niidre,estloxicologj�.cont. 193 99 Widwest To.Ticofogy In v oice @4es, Inc DATE INVOICE 603 East Washington Street, Suite 200, Indianapolis, IN 46204 3/3/2010 199746 BILL TO: SHIP TO: City of Carmel Names location of collection Attn: Jim Spelbring on invoices no ss 1 Civic Square Email results to Barb Lamb cc Jim Carmel, IN 46032 Still Mail results to Jim AA CONTROL P.O. NUMBER JOB SITE TERMS FACILITY 5528 Due on receipt 142376 ITEM CODE QTY DESCRIPTION PRICE EACH AMOUNT ND Drug Test CS 1 Non -DOT Drug Test 55.00 55.00 Collected at Community Occ. Health Center Carmel 3/2/10 Christopher Williams D Q MAR 15 2010 By A finance charge will be assessed on all invoices not paid in 30 days. Thank you for your business. For the purpose of client confidentiality we are no longer showing the full SSN on invoices. Total $55.00 Make Checks Payable To: MIDWEST TOXICOLOGY SERVICES, INC. For questions regarding this invoice, contact us at 317- 262 -2200 or fax us at 317 -262 -2222. Be sure to visit our website at wwrv.nridwesttovicolog.y.com. )93�E Midwest Toxicology I n voice Services, Inc DATE INVOICE 3/2/2010 199547 603 East Washington Street, Suite 200, Indianapolis, IN 46204 BILL TO: SHIP TO: City of Carmel Names location of collection Attn: Jim Spelbring on invoices no ss 1 Civic Square Email results to Barb Lamb cc Jim Carmel, IN 46032 Still Mail results to Jim CLz CONTROL P.O. NUMBER JOB SITE TERMS FACILITY 5528 Due on receipt 142376 ITEM CODE QTY DESCRIPTION PRICE EACH AMOUNT ND Drug Test CS 1 Non -DOT Drug Test 55.00 55.00 Collected at Community Occupational Health Center Carmel 02/25/10 Kip Benbow D Q MAR 15 2010 1 By A finance charge will be assessed on all invoices not paid in 30 days. Thank you for your business. For the purpose of client confidentiality we are no longer showing the full SSN on invoices. Total $55.00 Make Checks Payable To: MIDWEST TOXICOLOGY SERVICES, INC. For questions regarding this invoice, contact us at 317- 262 -2200 or fa_. us at 317- 262 -2222. Be sore to visit our wehsite at www.nridrvesttoxicology.conr. VOUCHER NO. WARRA NO. Midwest Toxicology ALLOWED 20 IN SUM OF 603 East Washington Street, Suite 200 Indianapolis, IN 46204 $199.00 ON ACCOUNT OF APPROPRIATION FOR Carmel HR Department PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members 19348 199547 43- 588.00 $55.00 1 hereby certify that the attached invoice(s), or 19348 199746 43- 588.00 $55.00 bill(s) is (are) true and correct and that the 19348 I 199698 I 43- 588.00 I $89.00 materials or services itemized thereon for which charge is made were ordered and received except Friday, March 12, 2010 1 irector, H% 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)) 03/02/10 199547 $55.00 03/03/10 199746 $55.00 03/03/10 I 199698 I I $89.00 1 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