185874 05/26/2010 CITY OF CARMEL, INDIANA VENDOR: 204038 Page 1 of 1
ONE CIVIC SQUARE MIDWEST TOXICOLOGY SVS,INC
CARMEL, INDIANA 46032 603 E WASHINGTON ST SUITE 200 CHECK AMOUNT: $660.00
INDIANAPOLIS IN 46204 CHECK NUMBER: 185874
CHECK DATE: 5/26/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1201 R4358800 19348 204916 55.00 TESTING FEES
1201 R4358800 19348 205039 385.00 TESTING FEES
1201 R4358800 19348 205252 110.00 TESTING FEES
1201 R4358800 19348 205366 110.00 TESTING FEES
1�3
�tidzvest 7oXicofogy I nvoice
o k w% g DATE INVOICE
603 East Washington Street, Suite 200, Indianapolis, IN 46204 5/13/2010 205366
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 2 Non -DOT Drug Test 55.00 110.00
Collected at Community Carmel
5!10!10
Cody Barlow
Stephanie Wilsey
MAY 2 4 2010
By
A finance charge wilt be assessed on alt invoices not paid in 30 days. Thank you for your business.
Thank you for your business! Total $110.00
Make Checks Payable To: MIDWEST TOXICOLOGY SE RVICES, INC.
For questions regarding this invoice, contact us at 317 -262 -2200 or fax us at 3.17- 262 -2222.
Be sure to visit our website at w►vw.tnidwesttoxicologl %cone.
Midwest 7oXicoCogy
Invoice
,Services, Ittc
lt, DATE INVOICE
603 East Washington Street, Suite 200, Indianapolis, IN 46204 5/12/2010 205252
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 2 Non -DOT Drug Test 55.00 110.00
Collected at Community Occ. Health Center Carmel
5/10!10
Aaron Goggan
Michael Wendt
D
MAY 2 4 2010
By
A finance charge will be assessed on all invoices not paid in 30 days. Thank you for your business.
Thank you for your business! Total $110.00
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.midwesttoxicology.com.
Midwest 7oxicofogy
Invoice
Services, Inc
DATE INVOICE
5/10/2010 204916
603 last 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
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 Occ. Health Center
515110
Alyssa Barker 8046
MAY 2 4 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 wwn:ntidwesttoxicology.cont.
91didwest TwCicofogy Invoice
Services, Inc.
DATE INVOICE
5/11/2010 205039
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
LW
CONTROL P.O. NUMBER JOB SITE TERMS FACILITY
5528 Due on receipt 142376
ITEM CODE QTY DESCRIPTION PRICE EACH AMOUNT
ND Drug Test 7 Non -DOT Drug Test 55.00 385.00
Collected at Community Occ Health
5/5110
Sharon Kibbe
Kelsey Vanvoorst
5/6110
Andrew Fritts
Andrew Pearcy
5/7110
Patrick Lux
Christopher Pearcy
Stefanie Wolf
D Q
MAY 2 4 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 $385.00
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 x,ww.midwesttoxicology.com.
VOUCHER NO. WARRANT NO.
ALLOWED 20
Midwest Toxicology
IN SUM OF
603 East Washington Street, Suite 200
Indianapolis, IN 46204
$660.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel HR Department
PO# 1 Dept. INVOICE NO. ACCT /TITt_E AMOUNT Board Members
19348 204916 43- 588.00 $55.00 1 hereby certify that the attached invoice(s), or
19348 205039 43- 588.00 $385.00 bill(s) is (are) true and correct and that the
19348 205252 43- 588.00 $110.00
materials or services itemized thereon for
19348 205366 43- 588.00 $110.00
which charge is made were ordered and
received except
Monday, May 24, 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))
05110/10 204916 $55.00
05/11/10 205039 $385.00
05/12/10 205252 $110.00
05/13/10 205366 $110.00
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
20
Clerk- Treasurer