HomeMy WebLinkAbout196112 03/29/2011 CITY OF CARMEL, INDIANA VENDOR: 361011 Page 1 of 1
ONE CIVIC SQUARE STATEWIDE MEDICAL SERVICES CHECK AMOUNT: $36.92
CARMEL, INDIANA 46032 3601 E 9TH ST
INDPLS IN 46201 -2511 CHECK NUMBER: 196112
CHECK DATE: 3/29/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1094 4350900 221637 36.92 OTHER CONT SERVICES
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STATEWIDE MEDICAL SERVICES INVOICE
Full Service Medical Waste Disposal
3601 East Ninth Street
Indianapolis, Indiana 46201-2511 Invoice Date Invoice
(317) 634 -0801 02/28/2011 221637
a
BAR 0 7 2011 Invoice Due: 3/30/2011
BY-.
1111J111111111111111111111 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
02/25/2011 Regulated Medical Waste 2.25 Cu. Ft. 289944 1 Containers $32.50 $32.50
Box
02/25/2011 Energy Surcharge 289944 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 -T
P.O.# PorF
G.L.
Budget
Line Descr 04jvr Xytt -SVGS
Purchaser Date
Approval Date
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
3601 E. 9th St. Date Due
Indianapolis, IN 46201 -2511
invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
2128111 221637 Regulated Medical Waste 36.92
Total 36.92
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
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 221637 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
24 -Mar 2011
Signature
36.92 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
I