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HomeMy WebLinkAbout218161 03/13/2013 CITY OF CARMEL, INDIANA VENDOR: 204038 Page 1 of 1 ONE CIVIC SQUARE MIDWEST TOXICOLOGY SVS,INC ` CARMEL,INDIANA 46032 603 E WASHINGTON ST SUITE 200 CHECK AMOUNT: $165.00 ?° INDIANAPOLIS IN 46204 CHECK NUMBER: 218161 CHECK DATE: 3/13/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1201 4358800 3930 55 . 00 TESTING FEES 1201 4358800 3782 110 . 00 TESTING FEES ----------------- - Midwest 7o.�icoCo 'Q Services,LL gy oo oam� Invoice i 603 E.Washington Street,Suite 200, Indianapolis,IN 46204 Date Invoice# Due on receipt 2/19/2013 3782 rAttnn* Ship To armel Spelbring Names & location of co llection quare on invoices - no ss#!! IN 46032 Email results to Barb Lamb & cc Jim . Still Mail results to Jim P.O. Number ---- Project/Jobsite Control# Rep 5528 DAC Qty. Item Code Description 2 ND Drug Test CS Non-DOT Drug Test Price Each Class Amount Collected at Community Occ. Health Center(MedCheck)-Carmel 55.00 Indiana 110.00 2/13/13 Andrea Stumpf Matthew Worthley D Q 0 MAR 1 12013 By A finance charge will be assessed on all invoices not paid in 30 days.Thank you for your business! Make checks payable to:Midwest Toxicology Services,LLC Total $110.00 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.midwesttoxicolo .com �Y @ w D Invoice Date Invoice# 603 E.Washington Street,Suite 200,Indianapolis,IN 46204 Due on receipt 2/20/2013 3930 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 2/18/13 Stephen Rejko D Q � MAR 1 2013 By A finance charge will be assessed on all invoices not paid in 30 days.Thank you for your business! Total 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 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)) 02/19/13 3782 $110.00 02/20/13 3930 $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 I VOUCHER NO. WARRANT NO. ALLOWED 20 Midwest Toxicology IN SUM OF $ 603 East Washington Street, Suite 200 Indianapolis, IN 46204 $165.00 ON ACCOUNT OF APPROPRIATION FOR Carmel HR Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1201 3782 43-588.00 $110.00 I hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and that the 1201 3930 43-588.00 $55.00 materials or services itemized thereon for which charge is made were ordered and received except Monday, March 11, 2013 /&-J"C "'j - Director, HR Title Cost distribution ledger classification if claim paid motor vehicle highway fund