158141 04/01/2008 J CITY OF CARMEL, INDIANA VENDOR: 361011 Page 1 of 1
ONE CIVIC SQUARE STATEWIDE MEDICAL SERVICES
o CARMEL, INDIANA 46032 3601 E 9TH Sr CHECK AMOUNT: $33.00
INDPLS IN 46201 -2511
+rew CHECK NUMBER: 158141
ra
CHECK DATE: 411/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1047 4341999 167582 33.00 OTHER PROFESSIONAL FE
STATEWIDE MEDICAL SERVICES INVOICE
Full Service Medical Waste Disposal
3601 East Ninth Street
Indianapolis, Indiana 46201-2511 Invoice Date Invoice
(3 17) 634 -0801 02/29/2008 167582
MAR 0 5 2008 Invoice Due: 3/30/2008
��I�e�elloo�I��eul0���1��0 Service Address:
CARMEL CLAY PARKS RECREATION CARMEL CLAY PARKS RECREATI
ATTN: ACCOUNTS PAYABLE 1235 CENTRAL PARK DRIVE EAST
1235 CENTRAL PARK DRIVE EAST CARMEL IN 46032
CARMEL IN 46032
,account Number 3210 -P.O: Number; Terms: Net 30
Date Description Manifest Department: Qty 1 Lbs Rate Amount
02/27/2008 New Customer Set -up 208133 1 $30.00 $30.00
02/27/2008 Energy Surcharge 208133 1 $3.00 $3 -00
Total $33.00
Sales Tax $0.00
Total Invoice Due $33.00
'Total past due (See below) $0.00
"Total Current and past due $74.50
Minimum amount due now $0.00
Amount due 3/30/2008 $3 .0
Current and outstanding unpaid invoice history:
Invoice Date Current 30 -60 60 -90 90+
166826 2/14/2008 $41.50 $0 -00 $0.00 $0.00
167582 2/29/2008 $33 -00 $0.00 $0.00 $0.00
Totals $74.50 $0.00 $0.00 $0.00
t
DESTRUCTION CERTIFIED
Waste destroyed in accordance with all applicable
federal, state, and local regulations. 3(la J
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
E 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 E. 9th Street Date Due
Indianapolis, IN 46201 -2511
Invoice Invoice Description
Date Number (or note attached invoices) or bill(s)) Amount
2129108 167582 Biowaste removal 3100
Total 33.00
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
1 20
Clerk- Treasurer
oucher No. Warrant No.
Allowed 20
Statewide Medical Services
3601 E. 9th Street
Indianapolis, IN 46201 -2511 In Sum of
33.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT XTITLE AMOUNT Board Members
Dept
1047 167582 4341999 33.00 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
27 -Mar 2008
nat re
33.00 Business Set/es Manager
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund