HomeMy WebLinkAbout203629 11/09/2011 CITY OF CARMEL, INDIANA VENDOR: 361011 Page 1 of 1
tI. ONE CIVIC SQUARE STATEWIDE MEDICAL SERVICES CHECK AMOUNT: $37.92
CARMEL, INDIANA 46032 3601 E 9TH ST
INDPLS IN 46201 -2511 CHECK NUMBER: 203629
CHECK DATE: 11/9/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1094 4350900 233220 37.92 OTHER CONT SERVICES
111111 IIIII IIIII IIIII Illfl IIIII Ills IIII
STATEWIDE MEDICAL SEIRVICES I NV OI CE
Full Service Medical Waste Disposal
3601 East N inth Street
Indianapolis, Indiana 46201-2511 Invoice Date Invoice
(3 l 7) 634 -0801 10/19/2011 233220
Invoice Due: 11/18/2011
1�1�el,ll��11a,�„II „�I,II Service Address:
CARMEL CLAY PARKS RECREATION CARMEL CLAY PARKS RECREATI
ATTN: ACCOUNTS PAYABLE MONON CENTER
1411 E. 116TH ST. 1235 CENTRAL PARK EAST
CARMEL IN 46032 CARMEL IN 46032 -3455
Accou Number: 3210 P.O. Number: I Terms:. Net 30
Date Description Manifest Department: Qty Lbs Rate Amount
10!1412011 Regulated Medical Waste 2.25 Cu. Ft. 307281 1 Containers $32.50 $32.50
Box
10/14/2011 Energy Surcharge 307281 1 $5.42 $5.42
Total $37.92
Sales Tax $0.00
Total Invoice Due $37.92
OCT Z 2011
DESTRUCTION CERTIFIED
Waste destroyed in accordance with all applicable
federal, state, and local regulations.
Purchase 1. WA96
Ppsr ription 2 1X� 4
P.O.# PorF
G. L.
LineJescr
Purchaser Date
Approval Date
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)) PO Amount
10/19/11 233220 Regulated Medical Waste 37.92
Total 37.92
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
Voucher No. Warrant No.
Allowed 20
361011 Statewide Medical Services
3601 E. 9th St.
Indianapolis, IN 46201 -2511 In Sum of
37.92
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1094 233220 4350900 37.92 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
3 -Nov 2011
Signature
37.92 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund