HomeMy WebLinkAbout196559 04/13/2011 CITY OF CARMEL, INDIANA VENDOR: 361011 Page 1 of 1
ONE CIVIC SQUARE STATEWIDE MEDICAL SERVICES
CARMEL, INDIANA 46032 3601 E 9TH ST CHECK AMOUNT: $36.92
INDPLS IN 46201 -2511
CHECK NUMBER: 196559
CHECK DATE: 4/13/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1094 4350900 222913 36.92 OTHER CONT SERVICES
111111 IIIII IIIII IIIII IIIII 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 3 0 9 W R 03/28/2011 222913
i MAR Y 1 201 Invoice Due: 4/27/2011
BY:
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: 1 3210 1 P.O. Number: Terms: Net 30
Date Description Manifest Department: Qty Lbs Rate Amount
03/25/2011 Regulated Medical Waste 2.25 Cu. Ft. 292046 1 Containers $32.50 $32.50
Box
03/2512011 Energy Surcharge 292046 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 REGl�L,4 M &I}lCX l_ W4g lLg
P.o. P or F
G.L. 109Ll- 443,5moo
Budget Ifs vie S
Line Descr
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 Date Due
3601 E. 9th St.
Indianapolis, IN 46201 -2511
Invoice Invoice Description Amount
Number (or note attached invoice(s) or bill(s)) PO
Date 36.92
3128111 222913 Regulated Medical Waste
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 222913 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
7 -Apr 2011
P&'LmnuA
Signature
36.92 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund