184849 04/27/2010 CITY OF CARMEL, INDIANA VENDOR: 204038 Page 1 of 1
t ONE CIVIC SQUARE MIDWEST TOXICOLOGY SVS,INC
s,. o CARMEL, INDIANA 46032 603 E WASHINGTON ST SUITE 200 CHECK AMOUNT: $110.00
INDIANAPOLIS IN 46204 CHECK NUMBER: 184849
CHECK DATE: 4/27/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1201 R4358800 19348 203526 55.00 TESTING FEES
1201 R4358800 19348 203556 55.00 TESTING FEES
Midwest Toxicotogy Invoi
0 4iii DATE INVOICE
603 East Washington Street, Suite 200, Indianapolis, IN 46204 4/20/2010 203526
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
LW
CONTROL P.O. NUMBER JOB SITE TERMS FACILITY
5528 Due on receipt 142376
ITEM CODE QTY DESCRIPTION PRICE EACH AMOUNT
ND Drug Test 1 Non -DOT Drug Test 55.00 55.00
Collected at Community Carmel
4!9110
Thomas Abel
APR 2 6 1 10
By
A finance charge will.be assessed on all invoices not paid in 30 days. Thank you for your business.
Thank you for your busin'essl 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 www.midwesitoricology.com.
9ididwest Toxicology Invoice
x 8y
N ow
DATE INVOICE
4/20/2010 203556
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
Email results to Barb Lamb cc Jim
1 Civic Square Still Mail results to Jim
Carmel, IN 46032
s
LW
CONTROL P.O. NUMBER JOB SITE TERMS FACILITY
5528 Due on receipt 142376
ITEM CODE QTY DESCRIPTION PRICE EACH AMOUNT
ND Drug Test 1 Non -DOT Drug Test 55.00 55.00
Collected at Community Carmel
4!13110-
Nathaniel Cloyd
D
APR 2 6 2
By
A finance charge Will assessed on all invoices not paid in 30 days. Thank you for your business.
For the purpose of client confidentiafity we are no longer showing the full SSN on invoices. Total $55.00
Make Checks Payahle 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 wehsite at www.midwestioxicology.com.
VOUCHER NO. WARRANT NO.
ALLOWED 20
Midwest Toxicology
IN SUM OF
603 East Washington Street, Suite 200
Indianapolis, IN 46204
$110.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel HR Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
3 I 203556 43-588.001 $55.00 1 hereby certify that the attached invoice(s), or
203526 I 43- 588.00 I $55.00
bill(s) is (are) true and correct and that the
materials or services itemized thereon far
which charge is made were ordered and
received except
Friday, April 23, 2010
Director, HR
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))
04/20/10 203556 $55.00
04/20/10 203526 I $55.00
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
1 20
Clerk- Treasurer