HomeMy WebLinkAbout229880 03/12/14 CITY OF CARMEL, INDIANA VENDOR: 355031
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ONE CIVIC SQUARE COMMUNITY OCCUPATIONAL HEALTH rIdROK AMOUNT: $****"**141.00*
CARMEL, INDIANA 46032 7169 SOLUTION CENTER CHECK NUMBER: 229880
'MiroH- CHICAGO IL 60677-7001 CHECK DATE: 03/12/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4340700 374866 47.00 MEDICAL FEES
1081 4340700 374926 47.00 MEDICAL FEES
1091 4340700 374926 47.00 MEDICAL FEES
Community Occupational Health Svs
7169 Solution Center
Chicago, IL 60677-7001
Phone: 317-621-0341
FEIN: 35-1955223
FDO
Invoice FEB 19 2014
February 14, 2014 ABP
Bill to: Lynn Russell For: Cannel Clay Parks & Recreation
Cannel Clay Parks & Recreation 2/14
1411 E. 116th St.
Cannel, IN 46032-
................ ........
Invoice# 374926
.............. .......
Proc Code Date Description QtV Charge Receipt &diust Balance
746404 02/04/2014 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Kevin G Hoblik Balance Due: 47.00
746404 02/06/2014 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Jessica M VanAsten Balance Due: 47.00
Invoice# 374926 Balance Due: 94.00
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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
2/14/14 374866 Pre-employment drug testing $ 47.00
2/14/14 374926 Pre-employment drug testing $ 47.00
2/14/14 374926 Pre-employment drug testing $ 47.00
Total $ 141.00
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$
$ 141.00
ON ACCOUNT OF APPROPRIATION FOR
101 General / 108 ESE/ 109 MCC
PO#or INVOICE NO. ACCT#/TITL AMOUNT Board Members
Dept#
1125 374866 4340700 $ 47.00 1 hereby certify that the attached invoice(s), or
1091 374926 4340700 $ 47.00 bill(s) is(are)true and correct and that the
1081-99 374926 4340700 $ 47.00 materials or services itemized thereon for
which charge is made were ordered and
received except
6-Mar 2014
$ 141.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund