HomeMy WebLinkAbout229263 2/12/2014 CITY OF CARMEL, INDIANA VENDOR: 355031 Page 1 of 1
ONE CIVIC SQUARE COMMUNITY OCCUPATIONAL HEALTH M&AMOUNT: $47.00
CARMEL, INDIANA 46032 7169 SOLUTION CENTER
a� CHICAGO IL 60677-7001 CHECK NUMBER: 229263
CHECK DATE: 2/12/2014
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4340700 372499 47 . 00 MEDICAL FEES
Community Occupational Health Svs
7169 Solution Center
Chicago, IL 60677-7001
Phone: 317-621-0341
FEIN: 35-1955223
[JAN 21 2014
Invoice
January 15, 2014
Bill to: Lynn Russell For: Carmel Clay Parks & Recreation
Carmel Clay Parks &Recreation 1/14
1411 E. 116th St.
Carmel, IN 46032-
- Invoice # 372499
Proc Code Date Description Qty Charge Receipt Adiust Balance
746404 01/09/2014 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Katherine S Meyer Balance Due: 47.00
Invoice# 372499 Balance Due: / 47.00
PLEASE REMIT PAYMENT PROMPTLY
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Cut and return with payment
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of 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.
355031 Community Occupational Health Services Terms
7169 Solution Center
Chicago, IL 60677-7001
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO# Amount
1/15/14 372499 Pre-employment drug testing $ 47.00
Total $ 47.00
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.
355031 Community Occupational Health Servic0s Allowed 20
7169 Solution Center
Chicago, IL 60677-7001
In Sum of$
$ 47.00
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1081-99 372499 4340700 $ 47.00 1 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
6-Feb 2014
$ 47.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund