HomeMy WebLinkAbout199114 07/06/2011 CITY OF CARMEL, INDIANA VENDOR: 204038 Page 1 of 1
ONE CIVIC SQUARE MIDWEST TOXICOLOGY SVS,INC
o CHECK AMOUNT: $165.00
CARMEL, INDIANA 46032 603 E WASHINGTON ST SUITE 200
INDIANAPOLIS IN 46204 CHECK NUMBER: 199114
CHECK DATE: 7/612011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1201 R4356800 21677 238037 165.00 TESTING FEES
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Midwest Taricology I
om INVOICE 603 East Washington Street, Suite 200, Indianapolis, IN 46204 6/20/2011 238037
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
DAC
CONTROL P.O. NUMBER JOB SITE TERMS FACILITY
5528 Due on receipt 142376
[TEM CODE QTY DESCRIPTION PRICE EACH AMOUNT
ND Drug Test CS 3 Non -DOT Drug Test 55.00 165.00
Collected at Community Occ. Health Center (MedCheck) Carmel
6/9/11
Alex Brown
6110/11
Mason Sy
Collected at Carmel St. Vincent Hospital
6/6/11
Charles Plumer
JUL 05 2011
By
A finance charge will be assessed on all invoices not paid in 30 days. Thank you for your business.
Thank you for your business! Total $165.00
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 wrvti nmidwesttoxicolo,-��.coni.
Prescribed by State Board of Accounts City 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))
06/20/11 I 238037 I I $165.00
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
Midwest Toxicology
IN SUM OF
603 East Washington Street, Suite 200
Indianapolis, IN 46204
$165.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel HR Department
PO# Dept. INVOICE NO. I ACCT /TITLE AMOUNT Board Members
21677 I 238037 j 43- 588.00 I $165.00 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
Thursday, June 30, 2011
Director, AR
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund