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Home My WebLink About159988 05/28/2008 T CITY OF CARMEL, INDIANA VENDOR: 204038 Page 1 of 1 y ONE CIVIC SQUARE MIDWEST TOXICOLOGY SVS,INC CHECK AMOUNT: $3,147.00 CARMEL, INDIANA 46032 603 E WASHINGTON ST SUITE 200 INDIANAPOLIS IN 46204 CHECK NUMBER: 159988 CHECK DATE: 5/28/2008 D EPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1201 4358800 152282 112.00 TESTING FEES 1 -201 4358800 152314 56.00 TESTING FEES 1201 4358800 152373 55.00 TESTING FEES 1201 4358800 152437 112.00 TESTING FEES 1201 4358800 152577 1,652.00 TESTING FEES 1201 4358800 152619 56.00 TESTING FEES 1201 4358800 152731 56.00 TESTING FEES 1201 4358800 152773 276.00 TESTING FEES 1201 4358800 152824 112.00 TESTING FEES I 1201 4358800 152985 660.00 TESTING FEES i Midwest Taidcofogy Invoice Services, Inc DATE INVOICE 5/8/2008 151745 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 MG 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, IN 5/5/08 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. We appreciate your business and thank you for your prompt payment. 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 Services, Inc. 0 DATE INVOICE 603 East Washington Street, Suite 200, Indianapolis, IN 46204 5/14/2008 152282 BILL TO: SHIP TO: City of Carmel No names or ss #'s Attn: Shelly Lingelbaugh 1 Civic Square Carmel, IN 46032 MG CONTROL P.O. NUMBER JOB SITE TERMS FACILITY 5528 Due on receipt 142376 CITY ITEM CODE DESCRIPTION PRICE EACH AMOUNT 2 ND Drug Test CS Non -DOT Drug Test 55.00 110.00 Collected at Community Occ. Health Center- Carmel, IN 5/7/08 2 Collection Site S... Please note that you are being charged an additional fee due to your 1.00 2.00 collection site urine collection charge. Pay your bills online at: https:// www. intuitbilipay. com /midwesttoxicologyservicesinc. 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 $112.00 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 Services, Inc. r DATE INVOICE z 5/14/2008 152373 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 TC CONTROL P.O. NUMBER JOB SITE TERMS FACILITY 5528 Due on receipt 142376 QTY ITEM CODE DESCRIPTION PRICE EACH AMOUNT 1 ND Drug Test M... Non -DOT Drug Test at Midwest Indpls 55.00 55.00 05/13/08 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 $55.00 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 Ta cofogy In Services, Inc. O DATE INVOICE 603 East Washington Street, Suite 200, Indianapolis, IN 46204 5/15/2008 152437 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 2 ND Drug Test CS Non -DOT Drug Test 55.00 110.00 Collected at Community Occ. Health Center Carmel Carmel, IN 5/07/08 5/12/08 2 Collection Site S... Please note that you are being charged an additional fee due to your 1.00 2.00 collection site urine collection charge. Pay your bills online at: https:// www. intuitbilipay. 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 $112.00 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 7o.zicofogy Invoice Seraices, Inc. Q DATE INVOICE 603 East Washington Street, Suite 200, Indianapolis, IN 46204 5/16/2008 152577 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 20 ND Drug Test OS Non -DOT Drug Test On -Site 55.00 1,100.00 5/14/08 8 DOT Test OS NC DOT Drug Test 55:00 440.00 Collected onsite 5/14 4 DOT Alcohol OS DOT Breath Alcohol Test On -Site 28.00 112.00 5/14/08 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 $1,652.00 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. tit idwesttoxicology.cont. Midwest Toxicofogy Invoice i Q Servi In c. DATE INVOICE 5/16/2008 152619 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 I 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 5/14/08 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.coni. Midwest 7oXicofogy Invoice Services Inc. DATE INVOICE fr 5/20/2008 152773 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 sc CONTROL P.O. NUMBER JOB SITE TERMS FACILITY 5528 Due on receipt 142376 QTY ITEM CODE DESCRIPTION PRICE EACH AMOUNT 2 DOT Test OS NC DOT Drug Test 55.00 110.00 Collected onsite 5/15/08 5/16/08 2 DOT Alcohol OS DOT Breath Alcohol Test On -Site 28.00 56.00 5/15/08 5/16/08 2 ND Drug Test OS Non -DOT Drug Test On -Site 55.00 110.00 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 $276.00 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.nridwesttoxicology.com. .w 96clwest Tx6cofogy Invoice S ervices, Inc. DATE INVOICE a 5/19/2008 152731 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 I 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 5/14/08 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. 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.midwesttoxicology.com. 1 Widwest ToXicofogy I n vo ice Services, Inc DATE INVOICE 603 East Washington Street, Suite 200, Indianapolis, IN 46204 5/21/2008 152985 BILL TO: SHIP TO: City of Carmel No names or ss #'s Attn: Shelly Lingelbaugh 1 Civic Square Carmel, IN 46032 TC CONTROL P.O. NUMBER JOB SITE TERMS FACILITY 5528 Due on receipt 142376 QTY ITEM CODE DESCRIPTION PRICE EACH AMOUNT 12 ND Drug Test OS Non -DOT Drug Test On -Site City of Carmel 55.00 660.00 05/16/08 2455 2348 362 095 2169 2392 094 2583 1023 938 353 262 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 $660.00 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. I Midwest 7ozicofogy Invoice ,Services, Inc. Q DATE INVOICE 5/20/2008 152824 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 2 ND Drug Test CS Non -DOT Drug Test 55.00 110.00 Collected at Community Occ. Health Center Carmel Carmel, IN 5/15/08 and 5 -16 -08 2 Collection Site S... Please note that you are being charged an additional fee due to your 1.00 2.00 collection site urine collection charge. Pay your bills online at: https://www.intuitbi11pay.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 $112.00 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.ntidwesttoxicologti cont. 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 ToxicoloOy Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 05/14/08 152282 Pre employment drug test $112.00 05/14/081 152373 Pre employment drug test $55.00 05/15/08 152437 Pre employment drug test $112.00 152577 Random Drug Testing $1,652.00 Ub/1 152619 Pre employment drug test $56.00 05/20108 1 152113 Random Drug Testing $276.00 051 i 9/0 8 152731 Pre-employment drug test $56.00 0512 152985 Random Drug I es ing $660.00 05/2 152824 Pre-employment rug test $112.00 5 -t l ex� u �jlo Total 1 l W7 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 IS/23/08WARRANT NO. Midwest Toxicology ALLOWED 20 IN SUM OF X03 E. Washington St., Suite 200 nd I N 462E)4 ON ACCOUNT OF APPROPRIATION FOR General Fund 1201 Human Resources Board Members PO# or INVOICE NO. ACCT #/TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and that the 1201 152282 588 $112.00 materials or services itemized thereon for 0 which charge is made were ordered and received except 1201 152437 588 $112.00 1201 152577 588 .0 1201 152619 588 0 T= 152773 588 $276.00 1201 15 588 $56. 0 20 r,-A�, J7 1201 152985 588 $660.00 S' ature Cost distribution ledger classification i Tltle t, claim pto highafunc eG Op