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Home My WebLink About172935 05/27/2009 CITY OF CARMEL, INDIANA VENDOR: 204038 Page 'I of 1 ONE CIVIC SQUARE MIDWEST TOXICOLOGY SVS,INC CHECK AMOUNT: $963.00 CARMEL, INDIANA 46032 603 E WASHINGTON ST SUITE 200 INDIANAPOLIS IN 46204 CHECK NUMBER: 172935 CHECK DATE: 5/2712009 DEPARTMENT Y ACCOU PO NUMBER INVOI NUMB AM OUNT DE SCRIP TION 1201 R4358800 19373 179770 55.00 TESTING FEES 1201 R4358800 19373 180025 385.00 TESTING FEES 1201 R4358800 19373 180303 83.00 TES`T'ING FEES 1201 R4358800 19373 180360 440.00 TESTING FEES ff l 91,fidwest 7ozicoCoBy Invoi Q Services, Inc. DATE INVOICE 5/18/2009 180360 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 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 8 Non -DOT Drug Test 55.00 440.00 Collected at Community Occ. Health Center Carmel, IN 5!9!09 Tiffanie Boyd 5111109 Sara McMullen Alex Miser 5112 Cody Barlow Tyler Kilfolf 5/13/09 Deborah Eggert James Spelbring Amy Ayers 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 $440.00 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 WF9N4tiiidwesnoxicolog,,.conz. W Widwest TwCicofogy Invoi o o wi o DATE INVOICE 603 East Washington 'Street, Suite 200, Indianapolis, IN 46204 5/15/2009 180303 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 OS 1 Non -DOT Drug Test 55.00 55.00 Collected Onsite 5111!09 Charles Driver ND Alcohol 1 Non -DOT Breath Alcohol Test 28.00 28.00 Collected Onsite 5111109 Charles Driver Pay your bills online at: https:// www. intuitbilipay. com /midwesftoxicologyservicesinc. A finance charge will be assessed on all invoices notpaid in 30 days. Thank you for your business. Thank you for your business! Total $83.00 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 wrvw.ntidwesttoxieology.cont. Midwest T'oxicofogy In vo i ce @4 DA TE INVOICE r 5/7/2009 603 East Washington Street, Suite 200, Indianapolis, IN 46204 179770 .,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 Center Carmel, IN 511109 Stephanie Wilsey Pay your bills online at: https://www.intultbilipay.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 Payabic 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.►rtidwesttoxicology.cona. id es co£o �f �v t 7o�,t gy Invo Services Inc DATE INVOICE 5/12/2009 180025 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 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 7 Non -DOT Drug Test 55.00 385.00 Collected at Community Occ. Health Center Carmel, IN 515109 Andrew Pearcy 516109 Andrew Shirley 517!09 Evie Anderson 518109 Eric Groganz Brian Finkbiner Kelsey Vanvoorst Alyssa Barker Pay your bills online at: https: liwww. intuitbillpay. comlmidwesttoxicologyservicesinc. 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 $385.00 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 wehsite at www.nnidrvesttoxicology.cont. Prescribed by 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. Midwest ToxicoloOyee Purchase Order No. Terms :c Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 80025 Pre employment drug test (7) $385.00 Pre employment drug test (1) $55.00 Post accident drug alcohol test (1) $83.00 0511810 180369 re -employment drug test (8) $440.00 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 UD /ZZ /0 VOL6 HER NO. -WARRANT NO. Idwest T ALLOWED 20 _603 E. Washingto, S t. Sclite 200 IN SUM OF Indianapolis, IN 46204 $963.00 ON ACCOUNTG6hWg p6nnJION FOR 1201 Human Resources Board Members 1# INVOICE NO. ACCT #(TITLE AMOUNT I hereby certify that the attached invoice(s), or partial 180025 588 bill(s) is (are) true and correct and that the materials or services itemized thereon for 19373 $55.00 which charge is made were ordered and partial 180303 received except 19373 PaFfi8j 180360 588 440.0 20 Sift e Cost distribution ledger classification if Title claim paid motor vehicle highway fund