HomeMy WebLinkAbout169541 03/04/2009 CITY OF CARMEL, INDIANA VENDOR: 204038 Page 1 of 1
ONE CIVIC SQUARE MIDWEST TOXICOLOGY SVS,INC CHECK AMOUNT: $110.00
CARMEL, INDIANA 46032 603 E WASHINGTON ST SOffE 200
INDIANAPOLIS IN 46204 CHECK NUMBER: 169541
CHECK DATE: 31412009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMB AMOUNT DESCRIPTION
1201 R4358800 19373 173171 55.00 TES'T'ING FEES
1201 R4358800 19373 174043 55.00 TESTING FEES
i
C k /7- 0)
Midwest 7oxicofogy c
@ffi DATE INVOICE
2/19/2009 174043
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
AH
CONTROL P.Q. 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
02/17/09
Jimmie Kitterman
Pay your bills online at:
https: /www.intuitbi[l pay. 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 $55.00
Make Checks Payable To: MIDWEST TOXICOLOGY SERVICES, INC.
For questions regarding this invoice, contact its at 317- 262 -2200 or fax us at 317 -262 -2222.
Be sure to visit our website at www.titidwesttoxicology.com.
Widwest ToXicofogy I
Services, Inc.
DATE INVOICE
2/17/2009 173171
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 #.l.
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
2111!09
Pamela Lister
Pay your bills online at:
https: /www.intuitbilipay. 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 orfax us at 317- 262 -2221.
Be sure to visit our website at www.midwesttoxicology.com.
Prep--!bed 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.
avee
Midwest Toxicoloby
Purchase Order No.
1.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
174043 Pre employment Drug Test (1) $55.00
02111/0 1 1 Pre employment Drug Test (1) $55.00
Total
1 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 tn NO.
M id west Toxicology
ALLOWED 20
603 E. Washington St., Suite 200 IN SUM OF
Indianapolis, I^N 4620
$110.00
ON ACCOUNT OF APPROPRIATION FOR
General Fund
1201 Human Resources
Board Members
PO# or D PT. 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
partial 588 $55.00 materials or services itemized thereon for
partial 1 0 which charge is made were ordered and
received except
20
ture
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund