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Home My WebLink About160989 06/25/2008 CITY OF CARMEL, INDIANA VENDOR: 204038 Page 1 of 1 ONE CIVIC SQUARE MIDWEST TOXICOLOGY SVS,INC 0 i CHECK AMOUNT: $499.00 CARMEL, INDIANA 46032 sos e WASHINGTON ST sulTe zoo INDIANAPOLIS IN 46204 CHECK NUMBER: 160989 CHECK DATE: 6/25/2008 DEPARTM ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTIO 1201 4358800 154137 55.00 TESTING FEES 1201 4358800 154204 224.00 TESTING FEES I 1201 4358800 154405 220.00 TESTING FEES j I e Midwest ToXicofogy I nvoice ow INVOICE 603 East Washington Street, Suite 200, Indianapolis, IN 46204 6/10/2008 154405 <n� 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 4 ND Drug Test CS Non -DOT Drug Test 55.00 220.00 Collected at Community Occ. Health Center Carmel Carmel, IN 6/05/08(3) 6/06/08(l) Pay your bills online at: https://www.intuitbiIIpay.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 $220.00 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.com. Midwest 7o.Vcofogy Invoice o DATE INVOICE 603 East Washington Street, Suite 200, Indianapolis, IN 46204 6/6/2008 154204 All 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 4 ND Drug Test CS Non -DOT Drug Test 55.00 220.00 Collected at Community Occ. Health Center Carmel Carmel, IN 5/29/08(l) 6/02/08(2) 6/03/08(l) 4 Collection Site S... Please note that you are being charged an additional fee due to your 1.00 4.00 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 $224.00 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 7oXicofogy Invoice offl DATE INVOICE 603 East Washington Street, Suite 200, Indianapolis, IN 46204 6/6/2008 154137 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 1 ND Drug Test M... Non -DOT Drug Test at Midwest Indianapolis 55.00 55.00 6/4/08 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 far us at 317 262 -2222. Be sure to visit our website at www.niidrvesttoxicology.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 ToxicoloDyee Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) D6 0/01 154405 Random Drug Tests (4) $220.00 154204 Random Drug Tests (4) $224.00 06/06/08 154137 Pre-employment Drug Test $55.00 Total qffZ _-U 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 N96123/_MWARRANT NO. Midwest J L Toxicol ogy ALLOWED 20 Washington St., Suite 200 IN SUM OF Indianapnli. IN 4620 $499.00 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 i2ei 154405 588 $22c). bill(s) is (are) true and correct and that the 0 materials or services itemized thereon for 1201 154204 588 0 which charge is made were ordered and 120 1 P !b4131 588 received except $55.00 20 r Sig tore Cost distribution ledger classification if Title claim paid motor vehicle highway fund