HomeMy WebLinkAbout201019 08/30/2011 CITY OF CARMEL, INDIANA VENDOR: 361011 Page 1 of 1
ONE CIVIC SQUARE STATEWIDE MEDICAL SERVICES CHECK AMOUNT: $75.84
CARMEL, INDIANA 46032 3601 E 9TH ST
N INDPLS IN 46201 -2511 CHECK NUMBER: 201019
CHECK DATE: 8130/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER A DESCRIPTION
1094 4350900 229166 37.92 OTHER CONT SERVICES
1094 4350900 229847 37.92 OTHER CONT SERVICES
STATEWIDE MEDICAL SERVICES INVOICE
Full Service Medical Waste Disposal
3601 East Ninth Street Elf NT
Indianapolis, Indiana 46201-2511 AUG 3 2 011 Invoice Date Invoice
(317) 634 =0801 07/31/2011 229166
Invoice Due: 8/30/2011
Service Address:
CARMEL CLAY PARKS RECREATION CARMEL CLAY PARKS RECREATI
ATTN: ACCOUNTS PAYABLE MONON CENTER
1411 E. 116TH ST. 1235 CENTRAL PARK EAST
CARMEL IN 46032 CARMEL IN 46032 -3455
Account Nu mber: 3210 P.O. Number: T Terms:.._ Net_30_
Date Description Manifest Department: Qty Lbs Rate Amount
07/29/2011 Regulated Medical Waste 2.25 Cu. Ft. 301511 1 Containers $32.50 $32.50
Box
07/29/2011 Energy Surcharge 301511 1 $5.42 $5.42
Tota 1 $37.92
Sales Tax $0.00
Total Invoice Due $37.92
DESTRUCTION CERTIFIED
Waste destroyed in accordance with all applicable
federal, state, and local regulations.
Purchase
Description
P.O. P or F
C.L. 435a9o�
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Line Descr Y C C)ntr 2� CS
Purchaser Date
Approval Date
111111 IIIII IIIII IIIII IINI !Ili/ IIII IIII
STATEWIDE MEDICAL SERVICES INVOICE
Full Service Medical Waste Disposal
3601 East Ninth Street
Indianapolis, Indiana 46201-2511 Invoice Date Invoice
(317) 634 -0801 08/11/2011 229847
Invoice Due: 9/10/2011
IAIAAIAIIAAIIAAAI Service Address:
CARMEL CLAY PARKS RECREATION CARMEL CLAY PARKS RECREATI
ATTN ACCOUNTS PAYABLE MONON CENTER
1411 E. 116TH ST. 1235 CENTRAL PARK EAST
CARMEL IN 46032 CARMEL IN 46032 -3455
Account Number: 3210 P.O. Number. Terms: Net 30
Date Description Manifest Department: Qty Lbs Rate Amount
08/05/2011 Regulated Medical Waste 2.25 Cu. Ft. 302049 1 Containers $32.50 $32.50
Box
08/05/2011 Energy Surcharge #302049 1 $5.42 $5.42
Total $37.92
Sales Tax $0.00
Total Invoice Due $37.92
DESTRUCTION CERTIFIED��
Waste destroyed in accordance with all applicable S AUG .1 201 G
federal, state, and local regulations.
D 1
Purchase Pe vI atccV
Description
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P or F
P.O.
G.L. t09L1 4 135090 0
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Line Descr O
Purchaser Date
Approval Date
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of 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.
361011 Statewide Medical Services
3601 E. 9th St. Date Due
Indianapolis, IN 46201 -2511
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
7/31/11 229166 Regulated Medical Waste 37'92
8/11/11 229847 Regulate Medical Waste 37'92
Total 75.84
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
361011 Statewide Medical Services
3601 E. 9th St.
Indianapolis, IN 46201 -2511 In Sum of
75.84
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1094 229166 4350900 37.92 1 hereby certify that the attached invoice(s), or
1094 229847 4350900 37.92 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
23 -Aug 2011
pa
Signature
75.84 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund