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Home My WebLink About216800 01/29/2013 CITY OF CARMEL, INDIANA VENDOR: 204038 Page 1 of 1 ONE CIVIC SQUARE MIDWEST TOXICOLOGY SVS,INC CHECK AMOUNT: $110.00 CARMEL, INDIANA 46032 603 E WASHINGTON ST SUITE 200 INDIANAPOLIS IN 46204 CHECK NUMBER: 216800 CHECK DATE: 1/29/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1201 4358800 1168 55 . 00 TESTING FEES 1201 4358800 750 55 . 00 TESTING FEES 9vl idwest 7o�r'coCogy Invoice Q*. Services,LGC Date Invoice# 603 E.Washington Street,Suite 200,Indianapolis,IN 46204 Due on receipt 1/14/2013 750 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 Community Occ.Health Center(MedCheck)-Carmel 1/11/13 Brandon Spelbring JAN 2 8 201 3 Q A finance charge will be assessed on all invoices not paid in 30 days.Thank you for your business! Total $55.00 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 Widwest Tarico6ogy Invoice @2ff es, C Date Invoice# 603 E.Washington Street,Suite 200,Indianapolis,IN 46204 Due on receipt 1/1812013 1168 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 Community Occ.Health Center(MedCheck)-Carmel 1/16/13 Linda White JAN 2013 A finance charge will be assessed on all invoices not paid in 30 days.Thank you for your business! Total $55.00 Make checks payable to:Midwest Toxicology Services,LLC For questions regarding this invoice,contact us at 317-269-3029 or fax us at 317-262-2222.Be sure to visit our website at www.midwesttoxicology.com VOUCHER NO. WARRANT NO. ALLOWED 20 Midwest Toxicology IN SUM OF$ 603 East Washington Street, Suite 200 Indianapolis, IN 46204 $110.00 ON ACCOUNT OF APPROPRIATION FOR Carmel HR Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1201 750 43-588.00 $55.00 hereby certify that the attached invoice(s), or bill(s) is (are)true and correct and that the 1201 1168 43-588.00 $55.00 materials or services itemized thereon for which charge is made were ordered and received except / Monday, January 28, 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)) 01/14/13 750 $55.00 01/18/13 1168 $55.00 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