HomeMy WebLinkAbout224587 09/25/2013 CITY OF CARMEL, INDIANA VENDOR: 366244 Page 1 of 1
ONE CIVIC SQUARE MEDASSURE
CARMEL, INDIANA 46032 1013 S GIRLS SCHOOL ROAD CHECK AMOUNT: $200.00
INDIANAPOLIS IN 46231 CHECK NUMBER: 224587
CHECK DATE: 9/2512013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 161902 200 . 00 OTHER EXPENSES
MedAssure CUSTOMER NO
MFD— AAF&% 1 013 S.Girls School Road
SSURE Indianapolis, IN 46231 000240
A SAFE AND CLEAN SOLUTION FOR YOUR MEDICAL WASTE STREAM (317)635-8000 INVOICE DATE
7/31/2013
INVOICE NO
0000161902
BILL TO: SERVICEADDRESS:
Carmel Household Hazardous Waste 901 N Range Line Rd
760 3rd AVE SW Carmel, IN 46032
Carmel, IN 46032
TERMS DUE DATE SALES REP
SERVICE DATE Net 15 Days 08/15/2013
DESCRIPTION QUANTITY UNIT PRICE AMOUNT
001 -Carmel Household Hazardous-901 N Range Line Rd
07/12/13 31 Gallon Mixed Waste Per Container 8.00 25.00 200.00
CURRENT 30 DAYS 60 DAYS 90 DAYS OVER 90 DAYS
AMOUNT DUE $200.00
200.00 0.00 0.00 0.00 0.00
TEAR ON ABOVE PERFORATED LINE AND RETURN STUB WITH PAYMENT
BILL TO: CUSTOMER NO INVOICE DATE INVOICE NO INVOICE AMOUNT
Carmel Household Hazardous 000240 7/31/2013 0000161902 $200.00
760 3rd AVE SW
Carmel, IN 46032 AMOUNT PAID CHECK NO
REMIT TO:
MedAssure
1013 S.Girls School Road
Indianapolis, IN 46231
Invoice#0000161902 Page 1 of 1
VOUCHER # 136362 WARRANT # ALLOWED
366244 IN SUM OF $
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
161902 01-736H-08 $200.00
Voucher Total $200.00
Cost distribution ledger classification if
claim paid under 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 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 9/17/2013
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
9/17/2013 161902 $200.00
I
1
I
hereby certify that the attached invoice(s), or bill(s) is (are) true and
;orrect and I have audited same in accordance with IC 5-11-10-1.6
I
113
Date Officer
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