The URL can be used to link to this page

Home My WebLink About208807 05/10/2012 CITY OF CARMEL, INDIANA VENDOR: 204038 Page 1 of 1 ONE CIVIC SQUARE MIDWEST TOXICOLOGY SVS,INC i CHECK AMOUNT: $2,507.00 CARMEL, INDIANA 46032 603 E WASHINGTON ST SUITE 200 INDIANAPOLIS IN 46204 CHECK NUMBER: 208807 CHECK DATE: 5/10/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1201 R4358800 26423 265736 55.00 TESTING FEES 1201 R4358800 26423 265981 55.00 TESTING FEES 1201 R4358800 26423 266385 1,395.00 TESTING FEES 1201 R4358800 26423 266577 727.00 TESTING FEES 1201 R4358800 26423 266767 275.00 TESTING FEES 9Kidwest Toxicology Inv oi ce Services, Inc DATE INVOICE 4/20/2012 265736 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 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 4/18/12 Gregory'Potter D Q MAY 7 2012 By A finance charge will be assessed all invoic not id in 30 days. Thank you for your business. d c ank you for your business. Total $55.00 Make Checks Payable To: MIDWEST TOXICOLOGI' 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.midwesttoxicology.com. Midwest 7oxicorogy ��Z3 Invoic Q Services, Inc O D +v DATE INVOICE 603 East Washington Street, Suite 200, Indianapolis, IN 46204 4/23/2012 265981 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 4/19/12 Logan Brock D Q MAY 7 2012 By A finance charge will be assessed all invoi es not id in 30 Mays. Thank you for your business. dank you c #or you��ustness. 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.midwestto_vicology.com. Midwest 7oxicotogy Invoic DATE INVOIC E 4/ 603 East Washington Street, Suite 200, Indianapolis, IN 46204 26/2012 266385 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 DOT Test OS 1 DOT Drug Test 55.00 Indiana 55.00 Collected Onsite 4/23/12 Joseph Faucett Fuel Surcharge 1 Fuel Surcharge 10.00 Indiana 10.00 DOT Test OS 1 DOT Drug Test 55.00 Indiana 55.00 Collected Onsite 4/24/12 Darryl Bell Parks Pifer Fuel Surcharge 1 Fuel Surcharge 10.00 Indiana 10.00 D Q MAY 7.2012 By A finance charge will be assessed cA all invoices not paid in 30 days. Thank you for your business. ankyou oryou usiness. Total $1,395.00 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.midwesttoxicology.cont. Page 3 Z�yZ3 Widwest Toxicofogy Invo Services, Inc. Q.- DATE INVOICE 4/26/2012 266385 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 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 4/23/12 Jordan Hicks D MAY 7.2012 By A finance charge will be assessed all invoi es not id in 30 days. Thank you for your business. dank you c #or you��usmess. Total 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.midwesttoxicology.com. Pagel 9Kidwest 7oXicoCogy Invoice DATE INVOICE 4/26/2012 266385 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 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... 22 Non -DOT Drug Test 55.00 Indiana 1,210.00 Collected Onsite 4/23/12 Mike Marsh Travis McNair Robert Harris John McNab Joel Heavner Ralph Gruwell Jared Kinney Charles Driver Michael Miller John Govin 4/24/12 Sarah Harris Jim Blanchard Daniel Spearman Wendell Howard Norman Riley Scott Pikington Frank Vallone James Davis William Akers Todd Luckoski Chad Zapf Jeffery Carpenter A finance charge will be assessed d c all invoic not id in 30 ank you for your business. �1ays. Thank you for your business. Total 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.midwesttoxicology.coni. Page 2 3 L Midwest 7o.zicofogy In voi ce DATE INVOICE 603 East Washington Street, Suite 200, Indianapolis, IN 46204 4/27/2012 266577 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 DOT Alcohol 4 DOT Breath Alcohol Test 28.00 Indiana 112.00 Collected Onsite Jeffrey Hicks James Hobbs Cameron Mason Crystal Edmondson Fuel Surcharge 1 Fuel Surcharge 10.00 Indiana 10.00 E .2012 A finance charge will be assessed all invoi es not id in 30 Pays. Thank you for your business. iankyour#oryou��usmess. Total $727.00 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.ntidwestioxicology.com. Page 2 .�'b9L -3 91didwest Toxicofogy Inv oic e DATE INVOICE 603 East Washington Street, Suite 200, Indianapolis, IN 46204 4/27/2012 266577 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... 2 Non -DOT Drug Test 55.00 Indiana 110.00 Collected at Community Occ. Health Center (MedCheck) Carmel 4/24/12 Ashley Collins 4/25/12 Robert Dykstra ND Drug Test... 3 Non -DOT Drug Test 55.00 Indiana 165.00 Collected Onsite 4/25/12 Jeffrey Grimes Eric Frenzel Timothy Zellers DOT Test OS 6 DOT Drug Test 55.00 Indiana 330.00 Collected Onsite 4/25/12 Jeffrey Hicks D James Hobbs Cameron Mason MAY 7 201 Tim Browning Crystal Edmondson Mike Clark By A finance charge will be assessed all invoic not id in 30 lays. Thank you for your business. d c ank you your business. Total 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 N Pagel G W idwest Toxicology I nv oice @4 DATE INVOICE v 603 East Washington Street, Suite 200, Indianapolis, IN 46204 5/11/2012 266767 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... 4 Non -DOT Drug Test 55.00 Indiana 220.00 Collected at Community Occ. Health Center (MedCheck) Carmel 4/27/12 Cameron Smith 4/30/12 Robert Pelzer Kari White Shane Collins DOT Test MT... 1 DOT Drug Test 55.00 Indiana 55.00 Collected at Community Occ. Health Center (MedCheck) Carmel 4/25/12 Randall Johnson D Q MAY 7 2012 13y A finance charge will be assessed all invoic not id in 30 days. Thank you for your business. d c ank you your business. Total $275.00 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 wtvw.ntidwesttoxicology.cont. 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)) 04/20/12 265736 $55.00 04/23/12 265981 $55.00 04/26/12 266385 $1,395.00 04/27/12 266577 $727.00 05/01/12 266767 $275.00 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 $2,507.00 ON ACCOUNT OF APPROPRIATION FOR Carmel HR Department PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members 26423 265736 43- 588.00 $55.00_ I hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and that the 26423 265981 43- 588.00 $55.00 materials or services itemized thereon for 26423 266385 43- 588.00 $1,395.00 which charge is made were ordered and 26423 266577 43- 588.00 $727.00 received except 26423 266767 43- 588.00 $275.00 Monday, May 07, 2012 4 Director, HR Title Cost distribution ledger classification if claim paid motor vehicle highway fund