The URL can be used to link to this page

210463 07/05/2012 CITY OF CARMEL, INDIANA VENDOR: 204038 Page 1 of 1 ONE CIVIC SQUARE MIDWEST TOXICOLOGY SVS,INC CHECK AMOUNT: $828.00 CARMEL, INDIANA 46032 603 E WASHINGTON ST SUITE 200 INDIANAPOLIS IN 46204 CHECK NUMBER: 210463 CHECK DATE: 715/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1201 4358800 270605 55.00 TESTING FEES 1110 4340701 271128 35.00 MEDICAL EXAM FEES 1201 4358800 271128 55.00 TESTING FEES 1201 4358800 271197 507.00 TESTING FEES 1201 4358800 271372 93.00 TESTING FEES 1201 4358800 271453 83.00 TESTING FEES y 23 Invoice 9KiQwest 7o.�icoCogy o fflwiiio DATE INVOICE 603 East Washington Street, Suite 200, Indianapolis, IN 46204 6/13/2012 270605 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 6/8/12 Steven Cash D Q JUL 0 2 2012 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.midwvesttoxicology.com. 914idwest Toxicofogy PAYMENT DUE Invo Services, Inc. UPON RECEIPT DATE INVOICE 603 East Washington Street, Suite 200, Indianapolis, IN 46204 r 6/20/2012 271128 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 I 1 Collected at Community Occ. Health Center (MedCheck) Carmel 06/12/12 Allen Valentine ND Alcohol CS 1 Non -DOT Breath Alcohol Test 28.00 Indiana 28.00 p I Le Collected at Community Occ. Health Center (MedCheck) Carmel 06/14/12 Bryan Hood BAT Surcharge 1 Please note that you are being charged an additional 7.00 Indiana 07.00 fee due to your collection site breath alcohol charges. D Q JUL 0 2 2012 By A finance charge will be assessed all invoic not id in 30 Ala s. Thank you for our business. U 9 dankyouctoryourbusiness. y y your Make Checks Payable To: MIDWEST TOXICOLOGY SERVICES, INC. SSC� 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 wwmmidwesttoxicologp.com. 2 G yz3 afidwest 7oxicofogy PAYMENT DUE Invo o ffl wiii UP ®N RECEIPT DATE INVOICE 603 East Wash Street, Suite 200, Indianapolis, IN 46204 1 6/21/2012 271197 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 7 DOT Drug Test 55.00 Indiana 385.00 Collected Onsite 6/18/1 LO) tq/ a Billy Higginbotham William Davis Nathaniel Morris Randall Johnson Aaron Hoover Jason Ogle Jerry Cloud DOT Alcohol 4 DOT Breath Alcohol Test 28.00 Indiana 112.00 Collected Onsite 6/18/12 Billy Higginbotham Nathaniel Morris Aaron Hoover Jerry Cloud Fuel Surcharge 1 Fuel Surcharge 10.00 Indiana 10.00 D Q JUL 0 2 2012 By A finance charge will be assessed all invoic not id in 30 days. Thank you for your business. l c ank you your business. Total $507.00 Make Checks Payable To: MIDWEST TOXICOLOGY SERVICES, INC. For questions regarding this invoice, eonlacl us at 317 -262 -2200 or fax us at 317 -262 -2222. Be sure to visit our website at www.midwestloxicology.com. 9Vtidwest 7oX icoeogy Invoice 0 INVOICE 603 East Washington Street, Suite 200, Indianapolis, IN 46204 6/22/2012 271372 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 6/21/12 Ralph Burke DOT Alcohol 1 DOT Breath Alcohol Test 28.00 Indiana 28.00 Collected Onsite 6/21/12 Ralph Burke Fuel Surcharge 1 Fuel Surcharge 10.00 Indiana 10.00 A finance charge will be assessed all invoic not id in 30 Pays. Thank you for your business. dank you you��usmess. Total $93.00 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.nddwestioxicoloAy.com. afidwest Taricology In 04iii DATE INVOICE 603 East Washington Street, Suite 200, Indianapolis, IN 46204 6/25/2012 271453 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 TSB 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 6/19/2012 Jeff Cooper 456 DOT Alcohol 1 DOT Breath Alcohol Test 28.00 Indiana 28.00 Collected Onsite 6/19/2012 Jeff Cooper 456 A fi? ncxchar a will le pssFsse%Sn 1u i voices not pp id in 3(�d s. T an�r� r rQur business. or a pu►�ose o c ►en con en ►a ►4y we are n onger s o ►ng e u o invoices. Tota $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 www.nddwesttoxicology.com 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)) 06/13/12 270605 $55.00 06/20/12 271128 $55.00 06/21/12 271197 $507.00 06/22/12 271372 $93.00 06/25/12 271453 $83.00 1 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. WARRAN N ALLOWED 20 Midwest Toxicology IN SUM OF 603 East Washington Street, Suite 200 Indianapolis, IN 46204 $793.00 ON ACCOUNT OF APPROPRIATION FOR Carmel HR Department PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members 26423 270605 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 271128 43- 588.00 $55.00 materials or services itemized thereon for 26423 271197 43- 588.00 $507.00 which charge is made were ordered and 26423 271372 43- 588.00 $93.00 received except 26423 271453 43- 588.00 $83.00 Wednesday, June 27, 2012 Director, HR Title Cost distribution ledger classification if claim paid motor vehicle highway fund 914idwest Toxicofogy AA N �p U� pp Inv oi ce Services, Inc ��NtlBl�uC1� �V� �P DATE INVOICE# UPON 0? 6/20/2012 271128 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 06/12/12 Allen Valentine ND Alcohol CS 1 Non -DOT Breath Alcohol Test 28.00 Indiana 28.00 p I Collected at Community Occ. Health Center (MedCheck) Carmel 06/14/12 Bryan Hood BAT Surcharge 1 Please note that you are being charged an additional 7.00 Indiana 0700 fee due to your collection site breath alcohol charges. A finance charge will be assessed all invoi es not id in 30 Mays. Thank you for your business. dank you you��usiness. Total $90.00 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. 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)) 06/20/12 271128 fit for duty $35.00 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 Services, Inc. IN SUM OF 603 E. Washington Street, Suite 200 Indianapolis, IN 46204 $35.00 ON ACCOUNT OF APPROPRIATION FOR Carmel Police Department PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members 1110 I 271128 I 43- 407.01 I $35.00 1 hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except Wednesday, June 27, 2012 Chief of Police Title Cost distribution ledger classification if claim paid motor vehicle highway fund