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Home My WebLink About160483 06/10/2008 CITY OF CARMEL, INDIANA VENDOR: 204038 Page 1 of 1 ONE CIVIC SQUARE MIDWEST TOXICOLOGY SVS,INC CARMEL, INDIANA 46032 603 E WASHINGTON ST SUITE 200 CHECK AMOUNT: $1,609.00 INDIANAPOLIS IN 46204 CHECK NUMBER: 160483 CHECK DATE: 6/10/2008 DEPARTMENT ACCOU PO NUMBER INVOICE NUMBER AMOUNT D ESCRIPTION 1201 4358800 153075 336.00 TESTING FEES 1201 4358800 153102 825.00 TESTING FEES 3 1201 4358800 153434 56.00 TESTING FEES 1201 4358800 153513 56.00 TESTING FEES; °1201 4358800 153635 280.00 TESTI,NG FEES 1201 4358800 153740 56.00 TESTING FEES. s f Midwest To.#cofogy Invoice Services, Inc. DATE INVOICE 6/2/2008 153740 603 East Washington Street, Suite 200, Indianapolis, IN 46204 BILL TO: SHIP TO: City of Carmel No names or ss #'s Attn: Shelly Lingelbaugh 1 Civic Square Carmel, IN 46032 PH CONTROL P.O. NUMBER JOB SITE TERMS FACILITY 5528 Due on receipt 142376 QTY ITEM CODE DESCRIPTION PRICE EACH AMOUNT 1 ND Drug Test CS Non -DOT Drug Test 55.00 55.00 Collected at Community Occ. Health Center Carmel Carmel, IN 5/28/08 1 Collection Site S... Please note that you are being charged an additional fee due to your 1.00 1.00 collection site urine collection charge. Pay your bills online at: https://www.intuitbilipay.com/midwesttoxicologyservicesinc. i A finance charge will be assessed on all invoices not paid in 30 days. Thank you for your business. For the purpose of client confidentiality we are no longer showing the full SSN on invoices. Total $56.00 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 www.n:idwesttoxicology.cont. W idwest ToXicofogy Invoice Services Inc. DATE INVOICE 603 East Washington Street, Suite 200, Indianapolis, IN 46204 5/29/2008 153513 BILL TO: SHIP TO: City of Carmel No names or ss #'s Attn: Shelly Lingelbaugh 1 Civic Square Carmel, IN 46032 PH CONTROL P.O. NUMBER JOB SITE TERMS FACILITY 5528 Due on receipt 142376 QTY ITEM CODE DESCRIPTION PRICE EACH AMOUNT 1 DOT Test CS NC DOT Drug Test 55.00 55.00 Collected at Community Occ. Health Center Carmel Carmel, IN 5/21/08 1 Collection Site S... Please note that you are being charged an additional fee due to your 1.00 1.00 collection site urine collection charge. Pay your bills online at: https://www.intuitbillpay.com/midwesttoxicologyservicesinc. A finance charge will be assessed on all invoices not paid in 30 days. Thank you for your business. For the purpose of client confidentiality we are no longer showing the full SSN on invoices. Total $56.00 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 www.midwesttoxicology.com. Midwest Toxicology Invoice omwes, Inc. r DATE INVOICE 5/29/2008 153434 603 East Washington Street, Suite 200, Indianapolis, IN 46204 BILL TO: SHIP TO: City of Carmel No names or ss #'s Attn: Shelly Lingelbaugh 1 Civic Square Carmel, IN 46032 PH CONTROL P.O. NUMBER JOB SITE TERMS FACILITY 5528 Due on receipt 142376 QTY ITEM CODE DESCRIPTION PRICE EACH AMOUNT 1 ND Drug Test CS Non -DOT Drug Test 55.00 55.00 Collected at Community Occ. Health Center- Carmel Carmel, IN 5/22/08 1 Collection Site S... Please note that you are being charged an additional fee due to your 1.00 1.00 collection site urine collection charge. Pay your bills online at: https://www.intuitbillpay.com/midwesftoxicologyservicesinc. A finance charge will be assessed on all invoices not paid in 30 days. Thank you for your business. For the purpose of client confidentiality we are no longer showing the full SSN on invoices. Total $56.00 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 wwminidwesttoxicology.coin. Midwest 7oXicofogy I nvoice o INVOICE 603 East Washington Street, Suite 200, Indianapolis, IN 46204 5/22/2008 153102 BILL TO: SHIP TO: City of Carmel No names or ss #'s Attn: Shelly Lingelbaugh 1 Civic Square Carmel, IN 46032 sc CONTROL P.O. NUMBER JOB SITE TERMS FACILITY 5528 Due on receipt 142376 QTY ITEM CODE DESCRIPTION PRICE EACH AMOUNT 15 ND Drug Test OS Non -DOT Drug Test On -Site 55.00 825.00 5/15/08 Pay your bills online at: https: /www.intuitbillpay. com /midwesttoxicologyservicesinc. A finance charge will be assessed on all invoices not paid in 30 days. Thank you for your business. For the purpose of client confidentiality we are no longer showing the full SSN on invoices. Total $825.00 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 wwm in idwesttoxicology. com. Widwest Tx6cofogy Invoice Seraices, Inc. OF r DATE INVOICE 603 East Washington Street, Suite 200, Indianapolis, IN 46204 5/22/2008 153075 BILL TO: SHIP TO: City of Carmel No names or ss #'s Attn: Shelly Lingelbaugh 1 Civic Square Carmel, IN 46032 PH CONTROL P.O. NUMBER JOB SITE TERMS FACILITY 5528 Due on receipt 142376 QTY ITEM CODE DESCRIPTION PRICE EACH AMOUNT 6 ND Drug Test CS Non -DOT Drug Test 55.00 330.00 Collected at Community Occ. Health Center Carmel Carmel, IN 5/19/08(3) 5/20/08(3) 6 Collection Site S... Please note that you are being charged an additional fee due to your 1.00 6.00 collection site urine collection charge. Pay your bills online at: https:// www. intuitbillpay. com /midwesttoxicologyservicesinc. A finance charge will be assessed on all invoices not paid in 30 days. Thank you for your business. For the purpose of client confidentiality we are no longer showing the full SSN on invoices. Total $336.00 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 www.niidwesttoxicology.com. Midwest Tozicofogy Invoice o m wiii DATE INVOICE 603 East Washington Street, Suite 200, Indianapolis, IN 46204 5/30/2008 153635 BILL TO: SHIP TO: City of Carmel No names or ss #'s Attn: Shelly Lingelbaugh 1 Civic Square Carmel, IN 46032 PH I CONTROL P.O. NUMBER JOB SITE TERMS FACILITY 5528 Due on receipt 142376 QTY ITEM CODE DESCRIPTION PRICE EACH AMOUNT 5 ND Drug Test CS Non -DOT Drug Test 55.00 275.00 Collected at Community Occ. Health Center Carmel Carmel, IN 5/24/08 (2) 5/25/08 (1) 5/27/08 (2) 5 Collection Site S... Please note that you are being charged an additional fee due to your 1.00 5.00 collection site urine collection charge. Pay your bills online at: https:// www. intuitbillpay. com /midwesttoxicologyservicesinc. I A finance charge will be assessed on all invoices not paid in 30 days. Thank you for your business. For the purpose of client confidentiality we are no longer showing the full SSN on invoices. Total $280.00 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 wehsite at www.midwesttoxicology.com. 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. Midwest Toxicoloftyee Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 153740 Pre employment drug test $56.00 513 11re- employment drug test $56.00 05/29/081 153434 Pre-employment drug test $56.00 Random Drug Tests $825.00 05/2 153075 Random Drug Tests $336.00 05/3 153635 Random Drug Vests $280.00 Total 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 N 6/09/08 ARRANT NO. ALLOWED 20 Washington St., Suite 200 IN SUM OF Indianapolis, IN 46204 $1,609.00 ON ACCOUNT 8F APPROPRIATION FOR eneral Fund 1201 Human Resources Board Members PO# or INVOICE NO. ACCT #/TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or 12011 1537-40 588 $513. bill(s) is (are) true and correct and that the 0 materials or services itemized thereon for 1201 153513 588 $56 0 which charge is made were ordered and received except 6.00 1201 153102 588 0 $336.00 1201 1 53635 s88 $280.0 20 Sign re Cost distribution ledger classification if Title claim paid motor vehicle highway fund