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Home My WebLink About209261 05/22/2012 CITY OF CARMEL, INDIANA VENDOR: 204038 Page 1 of 1 ONE CIVIC SQUARE MIDWEST TOXICOLOGY SVS,INC 4 CARMEL INDIANA 46032 603 E WASHINGTON ST SUITE 200 CHECK AMOUNT: $605.00 INDIANAPOLIS IN 46204 CHECK NUMBER: 209261 CHECK DATE: 5/22/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1201 R4358800 26423 266909 55.00 TESTING FEES 1201 4358800 267111 9.00 TESTING FEES 1201 R4358800 26423 267111 156.00 TESTING FEES 1201 R4358800 26423 267228 55.00 TESTING FEES 1201 4358800 267448 165.00 TESTING FEES 1201 4358800 267824 165.00 TESTING FEES WiQwest Toxicology Z Invoice ow wiii DATE INVOICE 603 East Washington Street, Suite 200, Indianapolis, IN 46204 4/30/2012 267228 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 AN 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 Onsite City of Carmel 04/25/2012 Justin M. Cox D Q MAY 2 12012 By A finance charge will be assessed oA all invoices not pgid in 30 days. 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 website at www.nd(hvesttoxicology.com. 3fidwest Toxicology 2b: Z,3 I nvo i ce 04� DATE INVOICE 603 East Washington Street, Suite 200, Indianapolis, IN 46204 5/3/2012 266909 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 5/1/12 Alyssa Barker D Q MAY 2 1202 By A finance charge will be assessed all invoi es not id in 30 Mays. Thank you for your business. dank you 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 website at www.midwesttoxicology.com. Midwest 7oxicofogy Inv Servaces, Inc. �p v DATE INVOICE 603 East Washington Street, Suite 200, Indianapolis, IN 46204 5/7/2012 267111 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... 3 Non -DOT Drug Test 55.00 Indiana 165.00 Collected at Community Occ. Health Center (MedCheck) Carmel 5/2/12 Jesse Miser 5/3/12 Matthew Morrisoey Bradley Ellis D Q MAY 2 1 2012 By A finance charge will be assessed all invoic not id in 30 lays. Thank you for your business. c ank you Tor your business. Total $165.00 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.com. Midwest ToXicofogy Invoice 0 DATE INVOICE 5/9/2012 267448 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... 3 Non -DOT Drug Test 55.00 Indiana 165.00 Collected at Community Occ. Health Center (MedCheck) Carmel 5/4/12 Gregory Loveall 5/7/12 Michael Coyne Margaret Ellis D MAY I L) 2 By A finance charge will be assessed all invoic not id in 30 flays. Thank you for your business. d c ank you for your business. Total $165.00 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 wwmmidwesttoxicologv.com. Midwest Toxicology Invoice 04� DATE INVOICE 603 East Washington Street, Suite 200, Indianapolis, IN 46204 5/15/2012 267824 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 NM CONTROL P.O. NUMBER JOB SITE TERMS FACILITY 5528 Due on receipt 142376 ITEM CODE QTY DESCRIPTION PRICE EACH CLASS AMOUNT ND Drug Test... 3 Non -DOT Drug Test 55.00 Indiana 165.00 Collected at Community Occ. Health Center (MedCheck) Carmel 5/9/12 Rachel Fernandez Tyler Hobbs 5/10/12 Andrew Loveall A finance charge will be assessed all invoi c es not id in 30 days. Thank you for your business. dankyoutoryoutP�us►ness. Total $1 65.00 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.conz. VOUCHER NO. WARRANT NO. ALLOWED 20 Midwest Toxicology IN SUM OF 603 East Washington Street, Suite 200 Indianapolis, IN 46204 $605.00 ON ACCOUNT OF APPROPRIATION FOR Carmel HR Department PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members 26423 267228 43- 588.00 $55.00 hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and that the 26423 266909 43- 588.00 $55.00 materials or services itemized thereon for 26423 267111 43- 588.00 $165.00 which charge is made were ordered and ZeV3 267448 43- 588.00 $165.00 received except 26A 267824 43- 588.00 $165.00 Monday, May 21, 2012 Director, HR Title Cost distribution ledger classification if claim paid motor vehicle highway fund 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)) 04/30/12 267228 $55.00 05/03/12 266909 $55.00 05/07/12 267111 $165.00 05/09/12 267448 $165.00 05/15/12 267824 $165.00 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