HomeMy WebLinkAbout209616 06/05/2012 Midwest 7o.zicoCogy
2 Invoice
DATE INVOICE
603 East Washington Street, Suite 200, Indianapolis, IN 46204 5/29/2012 269120
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
5/23/12
Brandon Spelbring
Zachery Zellers
D Q
JUN 4 2012
By
A finance charge will be assessed all invoi es not id in 30 days. Thank you for your business.
dank you c for you��usiness. Total $110.00
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.midwesttoxicolog},.eon1.
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))
05/23/12 268641 $310.00
05/25/12 269004 $55.00
05/29/12 269120 $110.00
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
$475.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel HR Department
M\
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
I hereby certify that the attached invoice(s), or
r—!!5 268641 43- 588.00 $310.00
bill(s) is (are) true and correct and that the
2 269004 43- 588.00 $55.00
materials or services itemized thereon for
26 269120 43- 588.00 $110.00
which charge is made were ordered and
received except
Monday, June 04, 2012
Director, HR
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund