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Home My WebLink About216454 01/15/2013 CITY OF O NRMEL, INDIANA VENDOR: 204038 Page 1 of 1 0 ONE CIVIC SQUARE MIDWEST TOXICOLOGY SVS,INC CHECK AMOUNT: $142.00 o CARMEL, INDIANA 46032 603 E WASHINGTON ST SUITE 200 o� INDIANAPOLIS IN 46204 CHECK NUMBER: 216454 CHECK DATE: 1/1512013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1201 4358800 155 88 . 00 TESTING FEES 1110 4341999 245 34 . 00 OTHER PROFESSIONAL FE 1201 4358800 280637 20 . 00 SHORT PAID INVOICE Midwest 7oxicoCogy Invoice Q'_ Services,GLC v, Date Invoice# 603 E.Washington Street,Suite 200,Indianapolis,IN 46204 Due on receipt 1/8/2013 245 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 -P:Q. 114uraber - ` —Project/Jobsite Control# Rep 5528 DAC Qty. Item Code Description Price Each Class Amount 1 ND Alcohol CS Non-DOT Alcohol Test 28.00 Indiana 28.00 Collected at Community Occ. Health Center(MedCheck)-Carmel 1/4/13 Bryan Hood 1 CS Surcharge Alcohol Please note that you are being charged an additional fee due to your 6.00 Indiana 6.00 collection site breath alcohol charges. A finance charge will be assessed on all invoices not paid in 30 days.Thank you for your business! Total $34.00 Make checks payable to:Midwest Toxicology Services,LLC For questions regarding this invoice,contact us at 317-269-3029 or fax us at 317-262-2222.Be sure to visit our website at www.midwesttoxicology.com VOUCHER NO. WARRANT NO. ALLOWED 20 Midwest Toxicology Services, Inc. IN SUM OF $ 603 E. Washington Street, Suite 200 Indianapolis, IN 46204 $34.00 ON ACCOUNT OF APPROPRIATION FOR Carmel Police Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1110 245 43-419.99 $34.00 I 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 Monday, January 14, 2013 Chief of Police 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)) 01/08/13 245 fit for duty $34.00 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 Midwest TxTicofogy Invoice Services, Inc. r[k Vir,V1.E N Tv D U E DATE INVOICE# UPON. RECEIPT 10/10/2012 280637 603 East Washington Street,Suite 200,Indianapolis,IN 46204 BILL TO: Fs—HiP To: City of Carmel i Names & location of collection i on invoices - no ss#!! Attn: Jim Spelbring Email results to Barb Lamb &cc Jim 1 Civic Square Carmel, IN 46032 Still Mail results to Jim KK CONTROL# P.O.NUMBER JOB SITE# TERMS FACILITY# 5528 Due on receipt 142376 ITEM CODE CITY DESCRIPTION PRICE EACH CLASS AMOUNT ND Drug Test... 4 Non-DOT Drug Test 55-00 Indiana Collected at Community Occ. Health Center (MedCheck)-Carmel, IN 10/02/12 Anthony Hoover David Haboush Stephen Reeves 10/04/12 'r1j Marc Deitsch ND Alcohol CS 1 Non-DOT Breath Alcohol Test 28.00 Indiana 28.00 Collected at Community Occ. Health Center (MedCheck)-Carmel, IN 10/03/12 Bryan Hood BAT Surcharge I Please note that you are being charged an additional 7.00 Indiana 7.00 fee due to your collection site breath alcohol charges. D Z /Z\ VN 14 2 3 D 0 1 01 OCT By— f 2 2 2 012 I By I I A finance charge will be assessed qA all invoices not paid in 30 days. Thank you for your business. ank you for your Dustness Total $255.00 Alake 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 webshe at)vii,)uniidivestto.vicologP.coni. �f idwest 7oxicoCogy Invoice (�; Services, GGC Date Invoice# 603 E.Washington Street,Suite 200,Indianapolis,IN 46204 Due on receipt 1/7/2013 155 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 P.O. Number Project/Jobsite Control# Rep 5528 DAC Qty. Item Code Description Price Each Class Amount 1 ND Drug Test CS Non-DOT Drug Test 55.00 Indiana 55.00 Collected at St.Vincent Carmel Hospital 1/3/13 Anthony Mowery 1 ND Alcohol CS Non-DOT Breath Alcohol Test 28.00 Indiana 28.00 Collected at St.Vincent Carmel Hospital 1/3/13 Anthony Mowery 1 CS Surcharge Alcohol Please note that you are being charged an additional fee due to your 5.00 Indiana 5.00 collection site breath alcohol charges. D JAN 14 2013 By A finance charge will be assessed on all invoices not paid in 30 days.Thank you for your business! Total $88.00 Make checks payable to:Midwest Toxicology Services,LLC For questions regarding this invoice,contact us at 317-269-3029 or fax us at 317-262-2222.Be sure to visit our website at www.midwesttoxicology.com VOUCHER NO. WARRANT NO. ALLOWED 20 Midwest Toxicology IN SUM OF $ 603 East Washington Street, Suite 200 Indianapolis, IN 46204 $108.00 ON ACCOUNT OF APPROPRIATION FOR Carmel HR Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1201 280637 43-588.00 $20.00 I hereby certify that the attached invoice(s), or bill(s) is (are)true and correct and that the 1201 155 43-588.00 $88.00 materials or services itemized thereon for which charge is made were ordered and received except Monday, January 14, 2013 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)) 10/10/12 280637 Correction $20.00 01/07/13 155 $88.00 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