HomeMy WebLinkAbout201327 09/13/2011 CITY OF CARMEL, INDIANA VENDOR: 204038 Page 1 of 1
ONE CIVIC SQUARE MIDWEST TOXICOLOGY SVS,INC CHECK AMOUNT: $330.00
is,�, /o CARMEL, INDIANA 46032 603 E WASHINGTON ST SUITE 200
INDIANAPOLIS IN 46204 CHECK NUMBER: 201327
CHECK DATE: 9/13/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1201 R4358800 21677 244480 55.00 TESTING FEES
1201 R4358800 21677 244626 165.00 TESTING FEES
1201 R4358800 21677 244887 55.00 TESTING FEES
1201 R4358800 21677 245007 55.00 TESTING FEES
Widwest 7ozicofogy Invoi
Q� Services, Inc.
DATE INVOICE
CAN 8/29/2011 244480
603 East Washington Street, Suite 200, Indianapolis, IN 46204
BILL TO: SHIP TO:
City of Carmel Names location of collection
Attn: Jim Spelbring on invoices no ss
1 Civic Square Email results to Barb Lamb cc Jim
Carmel, IN 46032 Still Mail results to Jim
Clz
CONTROL P.O. NUMBER JOB SITE TERMS FACILITY
5528 Due on receipt 142376
ITEM CODE QTY DESCRIPTION PRICE EACH AMOUNT
ND Drug Test CS 1 Non -DOT Drug Test 55.00 55.00
Collected at Community Occ Health
08/25/11
Heidi Babcock
U
D
SEP 12 2011 1
B y._
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 $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 wwmmidwesttoxicology.com.
'Ridwest 7oXicoCo
Services, Inc. gy Invoice
DATE INVOICE
p
8/31/2011 244626
603 East Washington Street, Suite 200, Indianapolis, IN 46204
BILL TO: SHIP TO:
City of Carmel Names location of collection
Attn: Jim Spelbring on invoices no ss
1 Civic Square Email results to Barb Lamb cc Jim
Carmel, IN 46032 Still Mail results to Jim
DAC
CONTROL P.O. NUMBER JOB SITE TERMS FACILITY
5528 Due on receipt 142376
ITEM CODE QTY DESCRIPTION PRICE EACH AMOUNT
ND Drug Test CS 3 Non -DOT Drug Test 55.00 165.00
Collected at Community Occ. Health Center (MedCheck) Carmel
8/28/11
Derrick Williams
8/29/11
Jeffrey Laker
Charles Whitaker
D,
�E 12 2011
By
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 $165 .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.midwesttoxicoloDwom.
9Kidwest 7oxicofogy Invoi
4 DATE INVOICE
8/31 /2011 244887
603 East Washington Street, Suite 200, Indianapolis, IN 46204
BILL TO: SHIP TO:
City of Carmel Names location of collection
Attn: Jim Spelbring on invoices no ss
1 Civic Square Email results to Barb Lamb cc Jim
Carmel, IN 46032 Still Mail results to Jim
DAC
CONTROL P.O. NUMBER JOB SITE TERMS FACILITY
5528 Due on receipt 142376
ITEM CODE QTY DESCRIPTION PRICE EACH AMOUNT
ND Drug Test CS 1 Non -DOT Drug Test 55.00 55.00
Collected at Community Occ. Health Center (MedCheck) Carmel
8/30/11
Heidi Babcock
S )r P 12 2011
By
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 $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 wwmmidwesttoxicology.com.
Midwest Toxicofogy )�j Q l q I nvo i c e
Inc.
DATE INVOICE
o ffl w es,
9/2/2011 245007
603 East Washington Street, Suite 200, Indianapolis, IN 46204
BILL TO: SHIP TO:
City of Carmel Names location of collection
Attn: Jim Spelbring on invoices no ss
1 Civic Square Email results to Barb Lamb cc Jim
Carmel, IN 46032 Still Mail results to Jim
DAC
CONTROL P.O. NUMBER JOB SITE TERMS FACILITY
5528 Due on receipt 142376
ITEM CODE QTY DESCRIPTION PRICE EACH AMOUNT
ND Drug Test CS 1 Non -DOT Drug Test 55.00 55.00
Collected at Community Occ. Health Center (MedCheck) Carmel
9/1/11
Clark Moser
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 $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.midwesttoxicolog} %corn.
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.
Payee
Purchase Order No.
Term s
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
08/29/11 244480 $55.00
08/31/11 244626 $165.00
08/31/11 244887 $55.00
09/02/11 245007 $55.00
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 NO. WARRANT NO.
ALLOWED 20
Midwest Toxicology
IN SUM OF
603 East Washington Street, Suite 200
Indianapolis, IN 46204
$330.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel HR Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
21677 244480 43- 588.00 $55.00 I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
21677 244626 43- 588.00 $165.00
materials or services itemized thereon for
21677 244887 43- 588.00 $55.00 which charge is made were ordered and
245007 43- 588.00 $55.00 received except
Monday, eptember 12, 2011
Director, HR
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund