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Home My WebLink About159490 05/14/2008 CITY OF CARMEL, INDIANA VENDOR: 204038 Page 1 of 1 f, ONE CIVIC SQUARE MIDWEST TOXICOLOGY SVS,INC CHECK AMOUNT: $167.00 CARMEL, INDIANA 46032 603 E WASHINGTON ST SUITE 200 INDIANAPOLIS IN 46204 CHECK NUMBER: 159490 CHECK DATE: 5/14/2008 DEPARTMENT ACCOUNT PO NUMBER INVOICE NU AMOUNT DESCRIPTION 1201 4358800 150788 55.00 TESTING FEES 1201 4358800 151227 56.00 TESTING FEES j 1201 4358800 151256 56.00 TESTING FEES f T.. s. 914idwest 7oxicofogy Invoice Services, Inc. o m DATE INVOICE 5/2/2008 151227 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 4/29/08 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. Widwest Toxicofogy Invoice o DATE INVOICE 603 East Washington Street, Suite 200, Indianapolis, IN 46204 5/2/2008 151256 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 DOT Test CS NC DOT Drug Test 55.00 55.00 Collected at Community Occ. Health Center Carmel Carmel IN 4/30/08 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 /midwesttoxicologysiarvicesinc. 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 Toxicofogy Invoi Q Services, Inc DATE INVOICE 4/29/2008 150788 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 CDT CONTROL P.O. NUMBER JOB SITE TERMS FACILITY 5528 Due on receipt 142376 QTY ITEM CODE DESCRIPTION PRICE EACH AMOUNT 1 ND Drug Test OS Non -DOT Drug Test On -Site 55.00 55.00 4/23/08 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. We appreciate your business and thank you for your prompt payment. 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 wwru.midwesttoxicology.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 Toxicology Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 05/02/OE 151227 Pre employment drug test $56.00 05/02/0 151256 Pre employment drug test $56.00 04/29/08 150788 Random drug test $55.00 Total 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 N NO. Midwest Toxicology ALLOWED 20 IN SUM OF Q03 E. Washington St., Suite 200 ndianapalis, IN 46284 $167.00 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 151227 588 $56.00 materials or services itemized thereon for .0 which charge is made were ordered and received except 1201 150788 588 $55.00 20 n 4- Cost distribution ledger classification if Title claim paid motor vehicle highway fund