157675 03/19/2008 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: $41.50
INDPLS IN 46201 -2511 CHECK NUMBER: 157675
CHECK DATE: 3119/2008
D EPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1047 4239099 166826 41.50 OTHER MISCELLANOUS
i
4
R ECE I VED
I VED
STATEWIDE MEDICAL SERVICES
171791 26 2008 Illllllllllllllllllllllllllllllllllllll
INVOICE
Full Service Medical Waste Disposal
3601 East Ninth Street
Indianapolis, Indiana 46201-2511 Invoice Date Invoice
(3 17) 634 -0801 T_ 02/14/2008 166826
r Invoice Due: 3/15/2008
lals�lolloell���e�ll��al�ll service Address:
CARMEL CLAY PARKS &RECREATION
C�� VED CARMEL CLAY PARKS RECREATI
ATTN: ACCOUNTS PAYABLE FEB 1 9 2008 1235 CENTRAL PARK DRIVE EAST
1235 CENTRAL PARK DRIVE EAST CARMEL IN 46032
CARMEL IN 46032 BY:
Account Number: 3210 P.O. Number: Terms: Net 30
Date Description Manifest Department: Qty I Lbs Rate Amount
02/08/2008 Regulated Medical Waste 4.5 Cu. Ft. 206770 1 Containers $38.50 $38.50
Box
02/08/2008 Energy Surcharge #206770 1 $3.00 $3.00
Total $41.50
Sales Tax $0.00
Total Invoice Due $41.50
'Total past due (See below) $0.00 1
'Total Current and past due $41.50
Minimum amount due now $0.00
Amount due 3115/2008 $41.50J
Current and outstanding unpaid invoice history:
Invoice Date Current 30 -60 60 -90 90+ {V
166826 2/14/2008 $41.50 $0.00 $0.00 $0.00 /),1
Totals $41.50 $0.00 $0.00 $0.00 v L
DESTRUCTION CERTIFIED
Waste destroyed in accordance with all applicable
federal, state, and local regulations.
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
`b 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.
4
Payee
Purchase Order No.
r
Statewide Medical Services Date Due
3601 E. 9th St.
Indianapolis, IN 46201 -2511
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2/14/08 166826 Waste disposal 41.50
Total 41.50
t 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
Statewide Medical Services
3601 E. 9th St.
Indianapolis, IN 46201 -2511 In Sum of
41.50
ON ACCOUNT OF APPROPRIATION FOR
104- Program Fund
PO# or Board Members
INVOICE NO. ACCT #ITITLE AMOUNT
Dept
10- 47 166826 4239099 41.50 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
13 -Mar 2008
Signa
41.50 Business Se Ice Mana er
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund