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Home My WebLink About230380 03/26/14 1 us.C.1q CITY OF CARMEL, INDIANA VENDOR: 355031 d Y. ONE CIVIC SQUARE COMMUNITY OCCUPATIONAL HEALTH e,19RQK AMOUNT: $*******521.00* ,? CARMEL, INDIANA 46032 7169 SOLUTION CENTER CHECK NUMBER: 230380 9.yi,oN_�o, CHICAGO IL 60677-7001 CHECK DATE: 03/26/14 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1081 4340700 375925 282.00 MEDICAL FEES 2201 4239099 377726 98.00 OTHER MISCELLANOUS 1081 4340700 378009 141.00 MEDICAL FEES Community Occupational Health Svs 7169 Solution Center Chicago, IL 60677-7001 Phone: 317-621-0341 FEIN: 35-1955223 Invoice March 04, 2014 Bill to: Jim Spelbring For: Cannel Street Dept. Cannel Street Dept. 2/14 1 Civic Square Carmel, IN 46032- Invoice# 377726 Proc Code Date Description ON Charge Receipt Adjust Balance 02/28/2014 Respirator Fit Test 1.00 49.00 49.00 Melinda S Etter XXX-XX-2099 Balance Due: 49.00 02/28/2014 Respirator Fit Test 1.00 49.00 49.00 Helen R Kittercnan XXX-XX-5545 Balance Due: 49.00 Invoice# 377726 Balance Due: 98.00 PLEASE REMIT PAYMENT PROMPTLY Cut and retum with payment Please remit 98.00 to Conununity Occupational Health Services 7169 Solution Center Please place invoice number 377726 on check Chicago, IL 60677-7001 Phone: 317-621-0341 VOUCHER NO. WARRANT NO. ALLOWED 20 Community Occupational Health Services IN SUM OF $ 7169 Solution Center Chicago, IL 60677-7001 $98.00 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 2201 I 377726 I 42-390.991 $98.00 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 rs arch 20, 2014 Street Com n1s0oner Street Gom" Ooner Cost distribution ledger classification if claim paid motor 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 service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 03/04/14 377726 $98.00 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 Community Occupational Health Svs 7169 Solution Center Chicago, IL 60677-7001 Phone: 317-621-0341 �'��T FEIN: 35-1955223 ED M 014 B Invoice March 04, 2014 Bill to: Lynn Russell For: Carmel Clay Parks & Recreation Cannel Clay Parks & Recreation 2/14 1411 E. 116th St. Cannel, IN 46032- Invoice # 375925 Proc Code Date Description Qty Char e Receipt Adjust Balance 746404 02/14/2014 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Isaac E Harris Balance Due: 47.00 746404 02/13/2014 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Krystal S Highbaugh Balance Due: 47.00 7464041-_ - - - 02/25/2014- -Drug Screen-Non NIDA 5 Panel 1.00_ 47.00 47.00 Amy Kelley Balance Due: 47.00 746404 02/15/2014 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Taunie M Nungester Balance Due: S 47.00 746404 02/13/2014 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Hannah R Wilska Balance Due: j 47.00 746404 02/20/2014 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Tara L Wright Balance Due: S 47.00 Invoice# 375925 Balance Due: ✓ 282.00 111 v��1111 PLEASE REMIT PAYMENT PROMPTLY Unle �escr U Purchase- Ap Date Cut and return with payment ;. Community Occupational Health Svs 7169 Solution Center Chicago, IL 60677-7001 Phone: 317-621-0341 FEIN: 35-1955223 ,� •�-, �..z�T�� MAR 1 7 2014 BY: Invoice March 13, 2014 Bill to: Lynn Russell For: Cannel Clay Parks & Recreation Cannel Clay Parks & Recreation 3/14 1411 E. 116th St. Cannel, IN 46032- Invoice # 378009 Proc Code Date Description Qty Charge Receipt Ad'lust Balance 746404 03/04/2014 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Robyn A Cody Balance Due: 47.00 746404 03/04/2014 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Mara Meyer Malian Balance Due: 47.00 746404 03/04/2014 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Hannali Nisonson Balance Due: 47.00 Invoice# 378009 Balance Due: f 141.00 PLEASE REMIT PAYMENT PROMPTLY tuq IsZ # ForF c.L.#ne Purchase :te 3 /� Approval_ Date 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 3/4/14 375925 Pre-employment drug testing $ 282.00 3/13/14- 378009 Pre-employment drug testing $ 141.00 Total $ 423.00 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 5-11-10-1.6 120— Clerk-Treasurer Voucher No. Warrant No. I 355031 Community Occupational Health Services Allowed 20 7169 Solution Center Chicago, IL 60677-7001 In Sum of$ $ 423.00 ON ACCOUNT OF APPROPRIATION FOR 108 PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members Dept# 1081-99 375925 4340700 $ 282.00;, 1 hereby certify that the attached invoice(s), or 1081-99 378009 4340700 $ 141.00, 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-Mar 2014 $ 423.00( Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund ,