HomeMy WebLinkAbout186430 06/09/2010 CITY OF CARMEL, INDIANA VENDOR: 204038 Page 1 of 1
t' ONE CIVIC SQUARE MIDWEST TOXICOLOGY SVS,INC
i CHECK AMOUNT: $275.00
CARMEL, INDIANA 46032 603 E WASHINGTON ST SUITE 200
la.i� INDIANAPOLIS IN 46204 CHECK NUMBER: 186430
CHECK DATE: 6/9/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1201 4358800 205648 24.00 TESTING FEES
1201 R4358800 19348 205648 31.00 TESTING FEES
1201 4358800 205895 110.00 TESTING FEES
1201 4358800 206718 55.00 TESTING FEES
1201 4358800 206897 55.00 TESTING FEES
Invoice Midwest Toxicology
Services, Inc.
DATE INVOICE
F5/21/2010 205895
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 Iamb 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 Occ. Health Carmel
05/19/10
Christopher Kauffman
ND Drug Test CS 1 Non -DOT Drug Test 55.00 55.00
Collected at Community Occ. Health Carmel
05/18/10
Andrew Loveall
D JUN 0 7 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 $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 3.17- 262 -2222.
Be sure to visit our website at www.nzidivesttoxicologv.com.
Midwest Toxicology Invo
services, 1'nc.
DATE INVOICE
603 East Washington Street, Suite 200, Indianapolis, IN 46204 6/2/2010 206897
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, IN
06/01/10
Greg Moffitt
D
JUN 0 7 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 www.ntidwestloxicoloDy.coni.
Midwest To.xicofogy 1 I3 A I
04� DATE INVOICE
603 East Washington Street, Suite 200, Indianapolis, IN 46204 6/1/2010 206718
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
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
05/27/10
Sarah Rutkowski
D
JUN 0 7 2010
8y
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 www nzidwesttoxicologv.eom.
19341
Widwest ?oXicofogy Inv
Q Services, Inc.
DATE INVOICE
5/18/2010 205648
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
CI 7
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, Carmel, IN
05/13/10
Alex Miser
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 3.17 -262 -2222.
Be sure to visit our website at www.midwesttoxicology.com.
VO NO. WAR NO.
ALLOWED 20
Midwest Toxicology
IN SUM OF
603 East Washington Street, Suite 200
Indianapolis, IN 46204
$275.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel HR Department
7348 t. INV6ICE NO. ACCT #/TITLE AMOUNT Board Members
205648 43- 588.00 $55.00 1 hereby certify that the attached invoice(s), or
19348 205895 43- 588.00 $110.00 bill(s) is (are) true and correct and that the
19348 206718 43- 588.00 $55.00
materials or services itemized thereon for
19348 206897 43- 588.00 $55.00
which charge is made were ordered and
received except
Monday, June 07, 2010
Director, HR
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed by State Board of Accounts amity 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))
05/18/10 205648 $55.00
05/21/10 205895 $110.00
06/01/10 206718 $55.00
06/02/10 206897 $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
20
Clerk- Treasurer