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Home My WebLink About203082 10/25/2011 CITY OF CARMEL, INDIANA VENDOR: 204038 Page 1 of 1 ONE CIVIC SQUARE MIDWEST TOXICOLOGY SVS,INC CHECK AMOUNT: $2,387.00 CARMEL, INDIANA 46032 603 E WASHINGTON ST SUITE 200 4.oNCa. INDIANAPOLIS IN 46204 CHECK NUMBER: 203082 CHECK DATE: 10/2512011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1201 4358800 248539 1,644.00 TESTING FEES 1201 4358800 248740 28.00 TESTING FEES 1201 R4358800 21677 248740 27.00 TESTING FEES 1201 4358800 248795 165.00 TESTING FEES 1201 4358800 248910 220.00 TESTING FEES 1201 4358800 249238 110.00 TESTING FEES 1201 4358800 249297 55.00 TESTING FEES 1201 4358800 249574 110.00 TESTING FEES 1201 4358800 249701 28.00 TESTING FEES Midwest 7oxicofogy In Inc. ow DATE INVOICE R 603 East Washington Street, Suite 200, Indianapolis, IN 46204 10/11/2011 248740 BILL TO: SHIP TO: City of Carmel Names location of collection Attn: Jim Spelbring on invoices no ss#!! Email results to Barb Lamb cc Jim. 1 Civic Square Carmel, IN 46032 Still Mail results to Jim MMD 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, IN. 10/03/2011 Clifford Stockton III D Lf OCT 2 4 2011 By A finance charge will be assessed on all invoices not paid in 30 days. Thank you for your business. For the purpose of client confidentiality we are no longer showing the full SSN on invoices. Total $55.00 Make Checks Payable To: MIDWEST TOXICOLOGY SERVICES, INC. For questions regarding this invoice, contact us at 317 -262 -2260 or fax us at 317- 262 -2222. Be sure to visit our website at www.midwesttoxicology.com Midwest Toxicology Invo Q� Ser'nices, Inc. DATE INVOICE 603 East Washington Street, Suite 200, Indianapolis, IN 46204 10/11 /2011 248795 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 10/10/11 Jeffery Bondurant F12G Adam Devenport f)b\ t E' ply Brent Liggett pUt 5 U OCT 2 4 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.niidwesttoxicologv.com. Midwest 7oXicoCogy Invo ,�Qm Services, Inc DATE INVOICE 603 East Washington Street, Suite 200, Indianapolis, IN 46204 10/11/2011 248539 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 KK CONTROL P.O. NUMBER JOB SITE TERMS FACILITY 5528 Due on receipt 142376 ITEM CODE QTY DESCRIPTION PRICE EACH AMOUNT DOT Test OS 5 DOT Drug Test 55.00 275.00 Collected Onsite 10/05/11 fY� Jaynes Haag Utilities Randy Massingill Utilities Calvin Cooper Utilities 10/07/11 Richard Walden Street Samuel Moffitt Street DOT Alcohol OS 3 DOT Breath Alcohol Test 28.00 84.00 Collected Onsite 10/05/11 James Haag Utilities Randy Massingill Utilities Calvin Cooper Utilities Fuel Surcharge 2 Fuel Surcharge 10/05/11 10/07/11 10.00 20.00 Lr 5 OCT 2 4 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 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.midrvesttoxicology.com. Pagel 'Mid Toxr:corogy Invo Q *R i DATE INVOICE 603 East Washington Street, Suite 200, Indianapolis, IN 46204 10/11/2011 248539 BILL TO: SHIP TO: City of Carmel Names location of collection Attn: Jim Spelbring on invoices no ss #I! 1 Civic Square Email results to Barb Lamb cc Jim Carmel, IN 46032 Still Mail results to Jim KK CONTROL P.O. NUMBER JOB SITE TERMS FACILITY 5528 Due on receipt 142376 ITEM CODE QTY DESCRIPTION PRICE EACH AMOUNT ND Drug Test -OS 23 Non -DOT Drug Test 55.00 1,265.00 Collected Onsite 10/05/11 Laura Mulligan Police Dennis Stilts CCCC Michael Delong Fire Matthew Hoffman Fire Dawn Pattyn Fire Matthew Broadnax Police Darcy Case CCCC Kent Paulin CCCC Rick Alvey Utilities Daniel Jenkins Utilities n Sean Whitlow- Utilities D Charles Driver Police Scott Pilkington Police OCT 2 4 2011 i f 10/06/11 Bryan Hood Police By Steven Edwards Fire Ronald Paddock Fire Travis McNair Fire David Henry Police Christopher Dunlap Police 10/07/11 Adam Miller Police Virgil Weaver Fire Michael Brisco Fire Adam Sharp Fire 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 $1,644.00 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 wehsite at wwntmidwesttoaico1o9y.coni. Page 2 Midwest Toxicology In 0 DA TE INVOICE z a 603 East Washington Street, Suite 200, Indianapolis, IN 46204 10/12/2011 248910 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 DOT Test 4 DOT Drug Test 55.00 220.00 Collected at Community Occ. Health Center (MedCheck) Carmel Eric Russell p S�YZLST William Davis sib 10/11/11 Dawn Pattyn Scott Stroup 1'l rz_& E 2011 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 $220.00 Make Checks Payable To: MIDWEST TOXICOLOGY SERVICES, INC. For questions regarding this invoice, contact us at 3.17- 262 -2200 or fax us at 377 -262 -2222. Be sure to visit our wehsite at ivww.uridrvesttaxicolog)7.coni. Midwest Toxicofogy Invo Services, Inc. SO D,. DATE INVOICE# C�. 603 East Washington Street, Suite 200, Indianapolis, IN 46204 10/14/2011 249238 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 2 Non -DOT Drug Test 55.00 110.00 Collected at Community Occ. Health Center (MedCheck) Carmel 10/12/11 Willie Collins Danny Jent 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 $110.00 Make Checks Payable To: MIDWEST TOXICOLOGY SERVICES, INC. For questions regarding this invoice, contact us at 317- 262 -2200 or fax us at 3.17- 262 -2222. Be sure to visit our website at ivivw.nudwesttoxicoingy.conr. Midwest Toxicofogy Invoi ,Services, Inc i DATE INVOICE 603 East Washington Street, Suite 200, Indianapolis, IN 46204 10/17/2011 249297 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 DOT Test 1 DOT Drug Test 55.00 55.00 Collected at Community Occ. Health Center (MedCheck) Carmel 10/13/11 William Davis D OCT 24 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: M IDWEST TOXICOLOGY SLRVICES, INC. For questions rezardinta this invoice, contact us at 317 262 -2100 orfax us at 317- 262 -2222. Be sure to visit our website at rrmiv.nridiresttoxicalnay.cnrn. %idwest 7oxicoCogy In v o ice Q Services, Inc. DATE INVOICE 10119120111 249574 603 East Washington Street, Suite 200, Indianapolis, IN 46204 BILL TO: SHIP TO: City of Carmel Names location of collection on invoices no ss Attn: Jim Spelbring Email results to Barb Lamb cc Jim 1 Civic Square Still Mail results to Jim Carmel, IN 46032 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 2 Non -DOT Drug Test 55.00 110.00 Collected at Community Occ. Health Center (MedCheck) Carmel 10/16/11 Anthony Hoover 10!17111 Jeffrey Sedberry D OCT 2 4 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 $110.00 Make Checks Pavable To: MIDWEST TOXICOLOGY SERVICES, INC. For questions re- arding this invoice, contact its at 317- 262 -2206 or fax us at 317- 262 -2222. Be sure to visit our website at www.inidwesttoxicoloz)%coin. Widwest Tozicorogy In vo i ce o INVOICE 603 East Washington Street, Suite 200, Indianapolis, IN 46204 10/20/2011 249701 BILL TO: SHIP TO: City of Carmel Names location of collection Attn: Jim Spelbring on invoices no ss Email results to Barb Lamb cc Jim 1 Civic Square Carmel, IN 46032 Still Mail results to Jim KK CONTROL P.O. NUMBER JOB SITE TERMS FACILITY 5528 Due on receipt 142376 ITEM CODE QTY DESCRIPTION PRICE EACH AMOUNT DOT Alcohol OS 1 DOT Breath Alcohol Test 28.00 28.00 Collected Onsite 10114/11 William Davis 6585 Street Fuel Surcharge 1 et Q OCT 24 2011 BY A finance charge will be assessed on all invoices not paid in 30 days. Thank you for your business. For the purpose of client confidentiality we are no longer showing the full SSN on invoices. Total Make Checks Payable To: MIDWEST TOXICOLOGI' SERVICES, INC. For questions regarding this invoice, contact us at 377- 262 -2200 ur' fax us at 317 262 2222. Be sure to visit our rvebsite at r� rt tv.niidrveslfoxicodo�.conr. VOUCHER NO. WARRANT NO. ALLOWED 20 Midwest Toxicology IN SUM OF 603 East Washington Street, Suite 200 Indianapolis, IN 46204 $2,387.00 ON ACCOUNT OF APPROPRIATION FOR Carmel HR Department PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members -\V?` r I hereby certify that the attached invoice(s), or 248740 43- 588.00 $55.00 bill(s) is (are) true and correct and that the 1201 248795 43- 588.00 $165.00 materials or services itemized thereon for 1201 248539 43- 588.00 $1,644.00 which charge is made were ordered and 1201 248910 43- 588.00 $220.00 received except 1201 249238 43- 588.00 $110.00 1201 249297 43- 588.00 $55.00 1201 249574 43- 588.00 $110.00 Monday, October 24, 2011 1201 249701 43- 588.00 $28.00 Director, HR Title Cost distribution ledger classification if claim paid motor vehicle highway fund 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. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 10/11/11 248740 $55.00 10/11/11 248795 $165.00 10/11/11 248539 $1,644.00 10/12/11 248910 $220.00 10/14/11 249238 $110.00 10/17/11 249297 $55.00 10/19/11 249574 $110.00 10/20/11 249701 $28.00 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 20 Clerk- Treasurer