HomeMy WebLinkAbout174431 07/08/2009 CITY OF CARMEL, INDIANA VENDOR: 204038 Page 1 of 1
0 ONE CIVIC SQUARE MIDWEST TOXICOLOGY SVS,INC
CHECK AMOUNT: $110.00
CARMEL, INDIANA 46032 603 E WASHINGTON ST SUITE 200
;y1r INDIANAPOLIS IN 46204
CHECK NUMBER: 174431
CHECK DATE: 71812009
DEPARTMENT ACCOUNT PO N INVOICE NUMBER AMOUNT DESC
1201 4358800 182894 55.00 TES'T'ING FEES
1201 4358800 182978 55.00 TESTING FEES
,�-r
Midwest 7oxicofogy Invo
09 ffi;io DATE INVOICE
6/22/2009 182978
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
MG
CONTROL P.Q. 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
6!19/09
Amy Milton
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 wwrv.midivesttoxicalogy.com.
Midwest Toxicofogy Invoi
Q Se1CeS' Inc. DATE INVOICE
6/22/2009 1 82894
603 East Washington Street, Suite 200, Indianapolis, IN 46204
s
a:
BILL TO: SHIP TO:
City of Carmel Names location of collection
Attn: Shelly Lingelbaugh on invoices no ss #II
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
6117109
Michael Baringer
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 $55.40
Make Checks Payable To: MIDWEST TOXICOLOGY SERVICES, INC.
For questions regarding this invoice, contact us at 317 262 -2200 or fun its at 317- 262 -2222.
Be sure to visit our wehsite at www.nnid >nesttoxicology.coni.
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 Toxicolos?y
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
06/22/09 182978 Pre employment drug test (1) $55.00
06/22/09 182894 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 RRANT NO.
Wes OXICe o� ALLOWED 20
3 E. Washington St., Suite 200 IN SUM OF
Indianapolis, IN 4222Q-4
$110.00
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
1120 1 1 82976 b6d bill(s) is (are) true and correct and that the
$55.00 materials or services itemized thereon for
1201 1 82894 588 which charge is made were ordered and
received except
20
Sign
e
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund