HomeMy WebLinkAbout219820 05/07/2013 "+yF CITY OF CARMEL, INDIANA VENDOR: 366244 Page 1 of 1
ONE CIVIC SQUARE MEDASSURE
CARMEL, INDIANA 46032 1013 S GIRLS SCHOOL ROAD CHECK AMOUNT: $175.00
INDIANAPOLIS IN 46231 CHECK NUMBER: 219820
CHECK DATE: 517/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 1542851 175 . 00 OTHER EXPENSES
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MeclAmure
1O13S. Girls School Road
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Indianapolis, iN40231
MED SS 03/3-1 1 2 1 01,3
A URE
(317) 835-8O00
Invoice ate',,
nvoiceNum
BILL TO:
Carmel Household Hazardous Waste
70O 3rd AVE GYV
Carmel, |N48032
TERMS DUE DATE SALES REP
SERVICE DATE Net 15 Days 04/15/2013
DESCRIPTION I CONT. COUNT IQTY/WGHT JUNIT PRICE I AMOUNT
001 -Carmel Household Hazardous-901 N Range Line Rd
Manifest#0000081803
03/07/13 31 Gallon Mixed Waste Per Container 1 7.00 25.00 175.00
CURRENT 30 DAYS 60 DAYS 90 DAYS OVER 90 DAYS nvoice Amount 175.00
175.00 0.00 0.00 9.00 175.00
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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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
366244
MEDASSURE Purchase Order No.
1013 S GIRLS SCHOOL ROAD Terms
INDIANAPOLIS, IN 46231 Due Date 5/1/2013
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
5/1/2013 1542851 $175.00
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
S/3114
Date Officer
I
VOUCHER # 135448 WARRANT # ALLOWED
IN SUM OF $
366244
MEDASSURE
1013 S GIRLS SCHOOL ROAD
INDIANAPOLIS, IN 46231
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
1542851 01-736H-08 $175.00
Voucher Total $175.00
Cost distribution ledger classification if
claim paid under vehicle highway fund