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HomeMy WebLinkAbout177317 09/15/2009 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: 177317 CHECK DATE: 9/15/2009 DEPART AC COUNT P O NUMBER INVOICE N UMBER AMOUNT DESCRIPTION 1201 4358800 187537 55.00 TESTING FEES '"R Midwest Toxicolo gy Invoice o ffi WiR i DATE INVOICE 603 East Washington Street, Suite 200, Indianapolis, IN 46204 9/2/2009 187537 BILL TO: SHIP TO: City of Carmel Names location of collection Attn: Shelly Lingelbaugh on invoices no ss 1 Civic Square Carmel, IN 46032 DMH 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 Comm. Occ. Health Carmel, IN 8/28/09 Brian Ballard 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.itzidwesttoxicology.com. ad b 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. Midwest Toxicolo& Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 09/02/09 187537 Pre employment drug test (1) $55.00 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 VOUCHEFO1 WARRANT NO. gy ALLOWED 20 W ashington St., Suite 200 IN SUM OF Indianapolis, IN 46204 $55.00 ON ACCOUNT OF APPROPRIATION FOR General Fund 1201 Human Resources Board Members PO# or INVOICE NO. ACCT #/TITLE AMOUNT DEPT. I 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 20 Sig azure f Title Cost distribution ledger classification if claim paid motor vehicle highway fund