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HomeMy WebLinkAbout178781 10/28/2009 CITY OF CARMEL, INDIANA VENDOR: 204038 Page 1 of 1 ONE CIVIC SQUARE MIDWEST TOXICOLOGY SVS,INC CHECK AMOUNT: $167.00 ;f CARMEL, INDIANA 46032 603 E WASHINGTON ST SUITE 200 INDIANAPOLIS IN 46204 CHECK NUMBER: 178781 CHECK DATE: 10/28/2009 V PARTMENT ACCOUN PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1201 4358800 190491 167.00 TESTING FEES Widwest 7oxicofogy Invo Services, Inc. DATE INVOICE 603 East Washington Street, Suite 200, Indianapolis, IN 46204 10/13/2009 190491 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 OS 1 Non -DOT Drug Test 55.00 55.00 Collected Onsite 10/7/09 James Barlow Police DOT Alcohol OS 4 DOT Breath Alcohol Test 28.00 112.00 Collected Onsite 10/8/09 Randy Massingill Utilities James Bentley Street Damian Delph Street Mike Clark Street 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 $167.00 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. i' Z'; 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. ll l llPayee Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 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. 2 WARRANT NO. ALLOWED 20 IN SUM OF 2, ON ACCOUNT OF APPROPRIATION FOR Board Members PO# or INVOICE NO. ACCT #/TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or iZ. -X 19049\ 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 Sigr�ture Cost distribution ledger classification if Title claim paid motor vehicle highway fund