HomeMy WebLinkAbout229434 2/25/2014 CITY OF CARMEL, INDIANA VENDOR: 355031 Page 1 of 1
` ONE CIVIC SQUARE COMMUNITY OCCUPATIONAL HEALTH CCK AMOUNT: $282.00
CARMEL, INDIANA 46032 7169 SOLUTION CENTER
CHICAGO IL 60677-7001 CHECK NUMBER: 229434
CHECK DATE: 2/25/2014
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4340700 373582 282 . 00 MEDICAL FEES
Community Occupational Health Svs
7169 Solution Center
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Chicago,,::IiG#iOn g0, IL 60677-7001
P or F Phone: 317-621-0341 �>�``1N
L 11 FEIN: 35-1955223 FEB 0 6 2014
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Date L BY:
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Invoice
February 04, 2014
Bill to: Lynn Russell For: Carmel Clay Parks &Recreation
Cannel Clay Parks & Recreation 1-14
1411 E. 116th St.
Carmel, IN 46032-
Invoice# 373582
Proc Code Date Description Qty Charge Rec i t Adjust Balance
746404 01/23/2014 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Stephanie Manuel Balance Due: 47.00
746404 01/20/2014 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Jamarr Moffett Balance Due: 47.00
746404 01/22/2014 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Sarah All Pachmayer Balance Due: 47.00
746404 01/22/2014 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Daniel J Paul Balance Due: 47.00
746404 01/22/2014 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Rachel M Servais Balance Due: 47.00
746404 01/23/2014 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
I Nicole L Young Balance Due: 47.00
I
Invoice# 373582 Balance Due: 282.00
PLEASE REMIT PAYMENT PROMPTLY
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
2/4/14 373582 Pre-employment drug testing $ 282.00
I
Total $ 282.00
1 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
Voucher No. Warrant No.
355031 Community Occupational Health Services Allowed 20
7169 Solution Center
Chicago, IL 60677-7001
In Sum of$
$ 282.00
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO#or Board Members
Dept#
INVOICE NO. CCT#/TITL AMOUNT
1081-99 373582 4340700 $ 282.00 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
20-Feb 2014
$ 282.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
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