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Home My WebLink About208387 04/25/2012 CITY OF CARMEL, INDIANA VENDOR: 204038 Page 1 of 1 ONE CIVIC SQUARE MIDWEST TOXICOLOGY SVS,INC CHECK AMOUNT: $497.00 aR, CARMEL, INDIANA 46032 603 E WASHINGTON ST SUITE 200 INDIANAPOLIS IN 46204 CHECK NUMBER: 208387 CHECK DATE: 4/25/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1201 R4358800 26423 264211 277.00 TESTING FEES 1201 R4358800 26423 264887 55.00 TESTING FEES 1201 R4358800 26423 265032 55.00 TESTING FEES 1201 R4358800 26423 265332 55.00 TESTING FEES 1201 R4358800 26423 265457 55.00 TESTING FEES 9Kidwest 7oXicoCogy Inv oice Services, Inc. Q' DATE INVOICE 603 East Washington Street, Suite 200, Indianapolis, IN 46204 3/31/2012 264211 BILL TO: SHIP TO: City of Carmel Names location of collection Attn: Jim Spelbring on invoices no ss 1 Civic Square Email results to Barb Lamb cc Jim Carmel, IN 46032 Still Mail results to Jim KK CONTROL P.O. NUMBER JOB SITE TERMS FACILITY 5528 Due on receipt 142376 ITEM CODE QTY DESCRIPTION PRICE EACH CLASS AMOUNT ND Drug Test... 4 Non -DOT Drug Test 55.00 Indiana 220.00 Collected at Community Occ. Health Center (MedCheck) Carmel 03/19/12 Louis Gatlin Jr. 03/21/12 Matthew Bickel 03/27/12 Elizabeth Ginther 03/30/12 Kristyn Campbell ND Drug Test... 1 Non -DOT Drug Test 55.00 Indiana 55.00 Collected at IU Health Occupational Services East (Formerly PromptCare East), Bloomington 03/28/12 Stefanie Wolf Collection Sit... 1 Please note that you are being charged an additional 2.00 Indiana 2.00 fee due to your collection site urine collection charge. D Q 0 APR 2 3 2012 By A finance charge will be assessed all invoi es not id in 30 days. Thank you for your business. dank you c #or youtP�ustness. Total $277.00 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.nridrvesttoxicologj�.cotn. Widwest ToXicofogy Invo Inc. 0 DATE INVOICE 4/18/2012 265457 603 East Washington Street, Suite 200, Indianapolis, IN 46204 BILL TO: SHIP TO: City of Carmel Names location of collection Attn: Jim Spelbring on invoices no ss 1 Civic Square Email results to Barb Lamb cc Jim Carmel, IN 46032 Still Mail results to Jim KK CONTROL P.O. NUMBER JOB SITE TERMS FACILITY 5528 Due on receipt 142376 ITEM CODE QTY DESCRIPTION PRICE EACH CLASS AMOUNT ND Drug Test... 1 Non -DOT Drug Test 55.00 Indiana 55.00 Collected at Community Occ. Health Center (MedCheck) Carmel 04/11/12 Ronald Hart D D APR 3 ?012 By A firprischar a will le psusse%a i11 i voices noVeid in 30 s. IAan� PrKqur business. or a puose o c ►en con en ra ►�y we are n onger s o ►ng e u o ►nvo►ces. 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.niidwestioxicology.com. 9Widwest 7oxicofogy Zb l Z I nvoice 04ii DATE INVOICE 603 East Washington Street, Suite 200, Indianapolis, IN 46104 4/11/2012 264887 BILL TO: SHIP TO: City of Carmel Names location of collection Attn: Jim Spelbring on invoices no ss#!! Email results to Barb Lamb cc Jim 1 Civic Square Carmel, IN 46032 Still Mail results to Jim CLz CONTROL P.O. NUMBER JOB SITE TERMS FACILITY 5528 Due on receipt 142376 ITEM CODE QTY DESCRIPTION PRICE EACH CLASS AMOUNT ND Drug Test... 1 Non -DOT Drug Test 55.00 Indiana 55.00 Collected at Community Occ. Health Center (MedCheck) Carmel 04/05/12 Eric Quintana D APR 23 2012 By A finance charge will be assessed w all s not a n 30 Pays. TThank you for your business. a nyou Total $55.00 Make Checks Payable To: MIDWEST TOXICOLOGY SERVICES, INC. For questions regarding this invoice, contact us at 317- 262 -1200 or far us at 317 -262 -2222. Be sure to visit our website at www.mirhvesttoxicology.com Midwest 7oxicofogy L/✓ I Services, Inc. O D k v DATE INVOICE 603 East Washington Street, Suite 200, Indianapolis, IN 46204 4/12/2012 265032 BILL TO: SHIP TO: City of Carmel Names location of collection Attn: Jim Spelbring on invoices no ss 1 Civic Square Email results to Barb Lamb cc Jim Carmel, IN 46032 Still Mail results to Jim KK CONTROL P.O. NUMBER JOB SITE TERMS FACILITY 5528 Due on receipt 142376 ITEM CODE QTY DESCRIPTION PRICE EACH CLASS AMOUNT ND Drug Test... 1 Non -DOT Drug Test 55.00 Indiana 55.00 Collected at Community Occ. Health Center (MedCheck) Carmel 04/09/12 Jennifer Gerber D Q APR 2 3 2012 By A finance charge will be assessed cA all invoices notpaid in 30 flays. Thank you for your business. ank you or you usiness. 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 rvebsite at wrvw.n►idwesttoxicology.com. Midwest 7oXicofogy Invo E! *W DATE INVOICE 603 East Washington Street, Suite 200, Indianapolis, IN 46204 4/17/2012 265332 BILL TO: SHIP TO: City of Carmel Names location of collection Attn: Jim Spelbring on invoices no ss 1 Civic Square Email results to Barb Lamb cc Jim Carmel, IN 46032 Still Mail results to Jim DAC CONTROL P.O. NUMBER JOB SITE TERMS FACILITY 5528 Due on receipt 142376 ITEM CODE QTY DESCRIPTION PRICE EACH CLASS AMOUNT ND Drug Test... 1 Non -DOT Drug Test 55.00 Indiana 55.00 Collected at Community Occ. Health Center (MedCheck) Carmel 4/13/12 Steven Scherich APR 2 3 2012 By A finance charge will be assessed all invoic not id in 30 flays. Thank you for your business. d c ank you your Dustness. 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 x,ww.nridwesttoxicology.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. Payee Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 03/31/12 264211 $277.00 04/11/12 264887 $55.00 04/12/12 265032 $55.00 04/17/12 265332 $55.00 04/18/12 265457 $55.00 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 NO. WARRANT NO. ALLOWED 20 Midwest Toxicology IN SUM OF 603 East Washington Street, Suite 200 Indianapolis, IN 46204 $497.00 ON ACCOUNT OF APPROPRIATION FOR Carmel HR Department PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members I hereby certify that the attached invoice(s), or 264 264211 43- 588.00 $277.00_ bill(s) is (are) true and correct and that the 26 3 264887 43- 588.00 $55.00 materials or services itemized thereon for 423 265032 43- 588.00 $55.00_ which charge is made were ordered and 2 4 4y" 265332 43- 588.00 $55.00_ received except 26423 265457 43- 588.00 $55.00 Monday, April 23, 2012 Direc tor, HR Title Cost distribution ledger classification if claim paid motor vehicle highway fund