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HomeMy WebLinkAbout179324 11/11/2009 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: $55.00 INDIANAPOLIS IN 46204 CHECK NUMBER: 179324 CHECK DATE: 11111/2009 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1201 4358800 191959 55.00 TESTING FEES Sgt Widwest 7o.Vcology Invoice Services, Inc. DATE INVOICE 11/5/2009 191959 603 East Washington Street, Suite 200, Indianapolis, IN 46204 BILL TO: SHIP TO: Names location of collection City of Carmel 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 LW CONTROL P.O. NUMBER JOB SITE TERMS rACILi I Y 5528 Due on receipt 142376 ITEM CODE QTY DESCRIPTION PRICE EACH AMOUNT ND Drug Test 1 Non -DOT Drug Test 55.00 55.00 Collected at Midwest Indianapolis 10/27/09 Lavernezetta Moore 0575 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 -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)) 11 s 191 SR h_" 7,'T 7" Total 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. w, ALLOWED 20 IN SUM OF J �5.,�� ON ACCOUNT OF APPROPRIATION FOR Board Members PO# or INVOICE NO. ACCT #!TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or 5s• 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 20 Sign re\ Title Cost distribution ledger classification if claim paid motor vehicle highway fund