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HomeMy WebLinkAbout178288 10/14/2009 CITY OF CARMEL, INDIANA VENDOR: 204038 Page 1 of 1 ONE CIVIC SQUARE MIDWEST TOXICOLOGY SVS,INC CHECK AMOUNT: $55.00 CARMEL, INDIANA 46032 603 E WASHINGTON ST SUITE 200 INDIANAPOLIS IN 46204 CHECK NUMBER: 178288 CHECK DATE: 10/14/2009 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AM DESCRIPTION 1201 4358800 189878 55.00 TESTING FEES `ZR Midwest Toxicology Invo 04� DATE INVOICE 603 East Washington Street, Suite 200, Indianapolis, IN 46204 10/6/2009 189878 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 MG CONTROL P.O. NUMBER JOB SITE TERMS FACILITY 5528 Due on receipt 142376 ITEM CODE QTY DESCRIPTION PRICE EACH AMOUNT DOT Test 1 DOT Drug Test 55.00 55.00 Collected at Community Occ. Health Center Carmel, IN 10/2/09 George M. Kalogeros 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 website at www.midwesttoxicology.com. R 1 1 Aresorits"d llg State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995) 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 1 co) Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) a 09 r7 g T, 5 4- Total 'Y, 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. j WARRANT NO. S ALLOWED 20 IN SUM OF ON ACCOUNT OF APPROPRIATION FOR Board Members PO# or INVOICE NO. ACCT #!TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or Izvl 1 -55- 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 nature Title Cost distribution ledger classification if claim paid motor vehicle highway fund