HomeMy WebLinkAbout172449 05/13/2009 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: $275.00
INDIANAPOLIS IN 46204 CHECK NUMBER: 172449
CHECK DATE: 5113!2009
DE PARTMENT ACCOUNT PO NUMB INVOICE NUMBE AMOUNT D ESCRIPTION
1201 R43.58800 19373 178759 55.00 TES'T'ING FEES
X201 R4358800 19373 179382 165.00 TESTING FEES
"1201 R4358800 19373 179635 55.00 TESTING FEES
Midwest Toxicology Invoi Seruiees, Inc
DATE INVOICE
5/6/2009 179635
603 East Washington Street, Suite 200, Indianapolis, IN 46204
BILL TO: SHIP TO:
City of Carmel Names location of collection
Attn: Shelly Lingelbaugh on invoices no ss
1 Civic Square
Carmel, IN 46032
KK
CONTROL P.O. NUMBER JOB SITE TERMS FACILITY
5528 Due on receipt 142376
ITEM CODE QTY DESCRIPTION PRICE EACH AMOUNT
ND Drug Test M... 1 Non -DOT Drug Test 55.00 55.00
Collected at Midwest Indianapolis
4130109
Kent Paulin
Pay your bills online at:
https:/Iwww.intuitbiltpay.com/midwesftoxicologyservicesinc.
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: A1dDWEST•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 www.ntidwestio.vicolol yi.cottt.
Midwest Toxicofogy Invoi
aQ Servues, Inc DATE INVOICE
603 East Washington Street, Suite 200, Indianapolis, IN 46204
5/4/2009 179382
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 3 Non -DOT Drug Test 55.00 165.00
Collected at Community Occ. Health Center Carmel, IN
4128109
Michael Calvert
4130109
Andrew Fritts
Matthew Bickel
Pay your bills online at:
https: l/ www. intuitbiIIpay. com /midwesttoxicologyservicesinc.
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 $165.00
Make Checks Payable To: MIDWEST TOXICOLOGY SERVICES, INC.
For questions regarding this invoice, contact us at 317- 262 -2200 orfax us at 3.17- 262 -2222.
Be sure to visit our website at www.ntidwesttoxi.cology.conr.
r q
36dwest Toxicofogy Invoice
Services, Inc.
DATE INVOICE
603 East Washington Street, Suite 200, Indianapolis, IN 46204
4/23/2009 178759
BILL TO: SHIP TO:
City of Carmel Names location of collection
Attn: Shelly Lingelbaugh on invoices no ss
1 Civic Square
Carmel, IN 46032
MG
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 Carmel, IN
4!20109
Hannah Calhoun
Pay your bills online at:
https:// www. intuitbiIIpay. com /midwesttoxicologyservicesinc.
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 websile 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.
Midwest Toxicology ayee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
5 04109 179382 Pre employment drug test (3) $165.00
79635 Pre employment drug test (1) $55.00
04723709 WVb9 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
VOUCHER N/ 1 /e9 WARRANT NO.
Midwest OXICO Ogy ALLOWED 20
603 E. Washington St., Suite 200 IN SUM OF
Indianapolis, IN 46620
$275.00
ON ACCOUNT OF APPROPRIATION FOR
General Fund
1201 Human Resources
Board Members
D PT. or INVOICE NO. ACCT #/TITLE AMOUNT I hereby certify that the attached invoice(s), or
19373 bill(s) is (are) true and correct and that the
65.00 materials'or services itemized thereon for
p artial 179635 which charge is made were ordered and
19373 received except
partial 8759 588 $55.00
20
'gnatur
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund