HomeMy WebLinkAbout191846 11/10/2010 CITY OF CARMEL, INDIANA VENDOR: 361011 Page 1 of 1
0 ONE CIVIC SQUARE STATEWIDE MEDICAL SERVICES CHECK AMOUNT: $36.92
CARMEL, INDIANA 46032 3601 E 9TH ST
INDPLS IN 46201 -2511 CHECK NUMBER: 191846
CHECK DATE: 11/10/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1094 4350900 215872 36.92 OTHER CONT SERVICES
1 111111 IIIII Illll !1111 Illli IIIII IIII IIII
STATEWIDE MEDICAL SERVICES INVOICE
Full Service Medical Waste Disposal
3601 East Ninth Street
Indianapolis, Indiana 46201-2511 Invoice Date Invoice
(3 17) 634 -0801 10/31/2010 215872
Invoice Due: 11/30/2010
lald�lell��ll�o���ll��ololl Service Address:
CARMEL CLAY PARKS RECREATION CARMEL CLAY PARKS RECREATI
ATTN: ACCOUNTS PAYABLE MONON CENTER
1411 E. 116TH ST. 1235 CENTRAL PARK EAST
CARMEL IN 46032 CARMEL IN 46032 -3455
Account Number: 3210 P.O. Number: Terms: Net 30
Date Description Manifest Department: Qty Lbs Rate Amount
10/29/2010 Regulated Medical Waste 2.25 Cu. Ft. 281207 1 Containers $32.50 $32.50
Box
10129/2010 Energy Surcharge 281207 1 $4.42 $4.42
Total $36.92
Sales Tax $0.00
Total Invoice Due $36.92
DESTRUCTION CERTIFIED
Waste destroyed in accordance with all applicable
federal, state, and local regulations.
Purchase
Description
P.O.# PorF
G.L.
Budget tlLi' ll �.�k:�(
Line Desc V Wj r
Purchaser Date 4 II
Approval t, t� NOV 0 2 20 10
BY........................
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of 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.
361011 Statewide Medical Services
Date Due
3601 E. 9th St.
Indianapolis, IN 46201 -2511
Invoice Invoice Description Amount
or note attached invoice(s) or bill(s
Date Number PO 36.92
10/31110 215872 Re ulated Medical Waste
Total 36.92
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
Voucher No. Warrant No.
Allowed 20
361011 Statewide Medical Services
3601 E. 9th St.
Indianapolis, IN 46201 -2511 In Sum of
36.92
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #!TITLE AMOUNT Board Members
Dept
1094 215872 4350900 36.92 1 hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
4 -Nov 2010
Signature
36.92 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund