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HomeMy WebLinkAbout160586 06/10/2008 CITY OF CARMEL, INDIANA VENDOR: 361011 Page 1 of 1 ONE CIVIC SQUARE STATEWIDE MEDICAL SERVICES CARMEL, INDIANA 46032 3601 E 9TH ST CHECK AMOUNT: $36.45 INDPLSIN 46201 -2511 CHECK NUMBER: 160586 CHECK DATE: 6/10/2008 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTIO 1047 4239012 171576 36.45 SAFETY SUPPLIES I I STATEWIDE MEDICAL SERVICES INVOICE Full Service Medical Waste Disposal 2 3601 East Ninth Street Indianapolis, Indiana 46201 -2511 61 Invoice Date Invo' (317) 634 -0801 05/15/200 Invoice Du 6/14/2008 5 Service Address: CARMEL CLAY PARKS RECREATION CARMEL CLAY PARKS RECREATI ATTN: ACCOUNTS PAYABLE 1411 E. 116TH ST. 1411 E. 116TH ST. CARMEL IN 46032 -3455 CARMEL IN 46032 Account Number: 3210 P.O. Number: Terms: Net 30 Date Description Manifest Department Qty Lbs Rate Amount 05/09/2008 Regulated Medical Waste 2.25 Cu. Ft. 213664 1 Containers $32.50 $32.50 Box 05/09/2008 Energy Surcharge 213664 1 $3.95 $3.95 Total $36.45 Sales Tax $0.00 Total Invoice Due $36.45 'Total past due (See below) $35.50 'Total Current and past due $144.85 Minimum amount due now $35.50 Amount due 6/14/2008 $36. 5 Current and outstanding unpaid invoice history: Invoice Date Current 30 -60 60 -90 90+ 169230 3/31/2008 $0.00 $35.50 $0.00 $0.00 170118 4/17/2008 $36.45 $0.00 $0.00 $0.00 170798 4/30/2008 $36.45 $0.00 $0.00 $0.00 171576 5/15/2008 $36.45 $0.00 $0.00 $0.00 Totals $109.35 $35.50 $0.00 $0.00 DESTRUCTION CERTIFIED Waste destroyed in accordance with all applicable federal, state, and local regulations. 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)) Amount 5115108 171576 Re ulated Medical Waste 36.45 Total 36.45 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 1 20 Clerk- Treasurer Voucher No. Warrant No. Allowed 20 361011 Statewide Medical Services 3601 F. 9th St. Indianapolis, IN 46201 -2511 In Sum of 36.45 ON ACCOUNT OF APPROPRIATION FOR 104 Program Fund PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members Dept.# 1047 171576 4239012 36.45 1 hereby certify that the attached invoice(s), or 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 4 -Jun 2008 Signature 36.45 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund