HomeMy WebLinkAbout198766 06/22/2011 CITY OF CARMEL, INDIANA VENDOR: 361011 Page 1 of 1
ONE CIVIC SQUARE STATEWIDE MEDICAL SERVICES
i e CHECK AMOUNT: $35.42
CARMEL, INDIANA 46032 3601E 9TH ST
INDPLS IN 46201 -2511 CHECK NUMBER: 198766
CHECK DATE: 6/22/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1094 4350900 226140 35.42 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
(3 17) 634 -0801 05/31/2011 226140
Invoice Due: 6/30/2011
D SUNW
J UN 0 3 2011
Service Address:
CARMEL CLAY PARKS RECREATION CARMEL CLAY PARKS RECREATI
ATTN:ACCOUNTS PAYABLE
By CENTER
1411 E. 116TH ST. 1235 CENTRAL PARK EAST
CARMEL IN 46032 CARMEL IN 46032 -3455
Account Number: 3210 P,.O._ Number: I Terms: N et_30_.
Date Description Manifest Department: Qty Lbs Rate Amount
05/27/2011 No Waste Wasted Trip Charge 297042 1 $30.00 $30.00
05/27/2011 Energy Surcharge 297042 1 $5.42 $5.42
Purchase Total $35.42
Description �EGLUJaTED �E�1 CA L WR Sales Tax $0.00
P.O.# PorF
10` L) Total Invoice Due $35.42
G.L.
Bud get h ei,- 30/gt &r VL CC-5 Line Descr
Purchaser Date
Approval Date
DESTRUCTION CERTIFIED
Waste destroyed in accordance with all applicable
federal, state, and local regulations.
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of bill to be properly itemized must show; k n d of service, units, price performed, dates sservice rendered, by
whom, rates per day, number of hours, rate per
Payee Purchase Order No.
361011 Statewide Medical Services Date Due
3601 E. 9th St.
Indianapolis, 1N 46201 -2511
Invoice Invoice Description PO Amount
Date Number (or note attached invoice(s) or bill(s)) 35.42
5!31111 226140 Re ulated Medical Waste
Total 35.42
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
35.42
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT ArrITLE AMOUNT Board Members
Dept
1094 226140 4350900 35.42 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
16 -Jun 2011
Signature
35.42 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund