HomeMy WebLinkAbout204398 12/06/2011 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: $70.42
INDPLS IN 46201 -2511
CHECK NUMBER: 204398
CHECK DATE: 12/6/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1094 4350900 234768 70.42 OTHER CONT SERVICES
STATEWIDE MEDICAL SERVICES INVOICE
Full Service Medical Waste Disposal
3601 East Ninth Street
Indianapolis, Indiana 46201-2511 Invoice Date Invoice
(3 17) 634 -0801 11/21/2011 234768
Invoice Due: 12/21/2011
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
Account Number: 3210 P.O. Number: Terms: Net 30
Date Description Manifest Department: Qty Lbs Rate Amount
11/11/2011 Regulated Medical Waste 2.25 Cu. Ft. 309595 2 Containers $32.50 $65.00
Box
11/11/2011 Energy Surcharge 309595 1 $5.42 $5.42
Total $70.42
Sales Tax $0.00
Total Invoice Due $70.42
P 9 TP12 17 Wr FIR,
i NOV 2 3 2011 V
DESTRUCTION CERTIFIED
Waste destroyed in accordance with all applicable
federal, state, and local regulations.
Purchase U 41
Description 74) WASTE gsym
P.O. J 0189 V r F
G.L. 1Q9A} 't3,50900
Budget
Line Descr OTI CGYVTR y! F.s
Purchaser ft�`' 0 K PE ADate
Approval 6,rn MOM h. E p ateabi
11 2 S1 I
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
11/21111 234768 Regulated Medical Waste 30189 70.42
Total 70.42
I hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and I have audited same in accordance
with IG 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
70.42
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1094 234768 4350900 70.42 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
1 -Dec 2011
Signature
70.42 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund