159616 05/14/2008 CITY OF CARMEL, INDIANA VENDOR: 361011 Page 1 of 1
e p ONE CIVIC SQUARE STATEWIDE MEDICAL SERVICES
CARMEL, INDIANA 46032 3601 E 9TH ST CHI=CK AMOUNT: $71.95
INDPLSIN 46201 -2511
CHECK NUMBER: 159616
CHECK DATE: 5/14/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1047 4239099 169230 35.50 OTHER MISCELLANOUS
1047 4239099 170118 36.45 OTHER MISCELLANOUS
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I
s
C EIVED
STATEWIDE MEDICAL SERVICES APR 2008
INVOIC
Full Service Medical Waste Disposal
3601 East Ninth Street
Indianapolis, Indiana 46201-2511 Invoice Date Invoice
(317) 634 -0801 03/31 /2008 169230
Invoice Due: 4/30/2008
APR I G 2008
C F ice Address:
A
CARMEL CLAY PARKS &RECREATION I 'RMEL CLAY PARKS RECREATI
ATTN: ACCOUNTS PAYABLE APR 2 2Q08 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 I Lbs Rate Amount
03/26/2008 Regulated Medical Waste 2.25 Cu. Ft. 210328 1 Containers $32.50 $32.50
Box
03/26/2008 Energy Surcharge 210328 1 $3.00 $3.00
Total $35.50
Sales Tax $0.00
Total Invoice Due $35.50
'Total past due (See below) $33.00
'Total urrent and past due $110.00
Minimum amount due now $33.00
Amount due 4/30/2008 $35.55
Current and outstanding unpaid invoice history: 1
Invoice Date Current 30 -60 60 -90 90+
167582 2/29/2008 $0.00 $33.00 $0.00 $0.00
168484 3/18/2008 $41.50 $0.00 $0.00 $0.00
169230 3/31/2008 $35.50 $0.00 $0.00 $0.00
Totals $77.00 $33.00 $0.00 $0.00
DESTRUCTION CERTIFIED
Waste destroyed in accordance with all applicable
federal, state, and local regulations.
,4 0 330 0 3 5 2 173 ?09 q
STATEWIDE MEDICAL SERVICES APR 2 1 2008 I
Full Service Medical Waste Disposal
3601 East plinth Street
Indianapolis, Indiana 46201-2511 Invoice Date Invoice
(317) 634 -0801 04/17/2008 170118
Invoice Due: 5/17/2008
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: I Terms: I Net 30
Date Description Manifest Department Qty Lbs Rate Amount
04/11/2008 Regulated Medical Waste 2.25 Cu. Ft. 211558 1 Containers $32.50 $32.50
Box
04/11/2008 Energy Surcharge 211558 1 $3.95 $3.95
Total $36.45
Sales Tax $0.00
Total Invoice Due $36.45
'Total past due (See below) $41.50
'Total Current and past due $113.45
Minimum amount due now $41.50
Amount due 5/1712008 $36.45
Current and outstanding unpaid invoice history:
Invoice Date Current 30 -60 60 -90 90+
168484 311812008 $0.00 $41.50 $0.00 $0.00
169230 3/31/2008 $35.50 $0.00 $0.00 $0.00
170118 4/1712008 $36.45 $0.00 $0.00 $0.00
Totals $71.95 $41.50 $0.00 $0.00
DESTRUCTION CERTIFIED
Waste destroyed in accordance with all applicable
federal, state, and local regulations.
'7'
30035 4-2- jq0qq
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.
Statewide Medical Services
3601 East Ninth Street Date Due
Indianapolis, In 46201 -2511
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
4/30/08 169230 Regulated Medical Waste 35.00
4/17/08 170118 Regulated Medical Waste 36.45
Total 79.45
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
20
Clerk Treasurer
w
4
Voucher No. Warrant No.
Allowed 20
Statewide Medical Services
3601 East Ninth Street
Indianapolis, In 46201 -2511 In Sum of
71.45
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE A UNT Board Members
Dept
1047 169230 4239099 -35-00 1 hereby certify that the attached invoice(s), or
1047 170118 4239099 36.45 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
12 -May 2008
Si a ure
71.45 Business Services Manager
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund