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Home My WebLink About206357 02/14/2012 CITY OF CARMEL, INDIANA VENDOR: 204038 Page 1 of 1 ONE CIVIC SQUARE MIDWEST TOXICOLOGY SVS,INC CARMEL, INDIANA 46032 603 E WASHINGTON ST SUITE 200 CHECK AMOUNT: $165.00 INDIANAPOLIS IN 46204 CHECK NUMBER: 206357 CHECK DATE: 2/14/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1201 R4358800 26423 258241 55.00 TESTING FEES 1201 R4358800 26423 258888 110.00 TESTING FEES Widwest 7oxicology Invo Services, Inc. 4f 'jz3 Q` DATE INVOICE 1 /31/2012 258241 603 East Washington Street, Suite 200, Indianapolis, IN 46204 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 ND Drug Test CS 1 Non -DOT Drug Test 55.00 55.00 Collected at Community Occ. Health Center (MedCheck) Carmel 01/25/12 Amanda Foley D Q FEB 13 2012 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: 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 wwminidwesttoxicolog►y.coin. Midwest 7oxicotogy 2 0z -3 z O DATE INVOICE603 East Washington Street, Suite 200, Indianapolis, IN 46204 2/7/2012 258888 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 ND Drug Test CS 2 Non -DOT Drug Test 55.00 110.00 Collected at Community Occ. Health Center (MedCheck) Carmel 01/31/12 Jimmie Kittermen 3108 Clay Campbell 3397 D Q FEB 13 2012 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 $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 317 -262 -2222. Be sure to visit our website at www.midwesttoxicology.com. 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)) 01/31/12 258241 $55.00 02/07/12 258888 $110.00 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 VOUCHER NO. WARRANT NO. ALLOWED 20 Midwest Toxicology IN SUM OF 603 East Washington Street, Suite 200 Indianapolis, IN 46204 $165.00 ON ACCOUNT OF APPROPRIATION FOR Carmel HR Department PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members 26423 258241 43- 588.00 $55.00 I hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and that the 26423 258888 43- 588.00 $110.00 materials or services itemized thereon for which charge is made were ordered and received except Monday, February 13, 2012 Director, H R Title Cost distribution ledger classification if claim paid motor vehicle highway fund