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Home My WebLink About231618 04/23/14 a'm C4gM w. CITY OF CARMEL, INDIANA VENDOR: 355031 d ONE CIVIC SQUARE COMMUNITY OCCUPATIONAL HEALTH ROK AMOUNT: $*******282.00* CARMEL, INDIANA 46032 7169 SOLUTION CENTER CHECK NUMBER: 231618 s ,roN Eo, CHICAGO IL 60677-7001 CHECK DATE: 04/23/14 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1081 4340700 378941 188.00 MEDICAL FEES 1082 4340700 378941 94.00 MEDICAL FEES Community Occupational Health Svs Pi;rrhI;) n n ^ 7169 Solution Center c ;P;ion x,�V Chicago, IL 60677-7001 P or F TSS) Phone: 317-621-0341 � G I FEIN: 35-1955223 APR - _ 7 2014 Purchase , Date pproval Da�tle o0 q — ! J l U 7 0 0 - t/1q.- Invoice 0 g,�- q 9 — �3y, 7 UO - t ?/, odApril 03, 2014 Bill to: Lynn Russell For: Carmel Clay Parks & Recreation Carmel Clay Parks & Recreation 3/14 1411 E. 116th St. Carmel, IN 46032- �� Invoice # 378941 Proc Code Date Description Qty Charge Recei t Adjust Balance 746404 03/11/2014 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 C Joshua E Clark Balance Due: 47.00 746404 03/25/2014 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 ll'latthew A Gregory Balance Due: 47.00 746404 03/11/2014 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Constance S Miller Balance Due: 47.00 746404 03/11/2014 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Audrey A Ruhl Balance Due: 47.00 746404 03/14/2014 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Sydney L Smith Balance Due: 47.00 746404 03/27/2014 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Jaret C Snellenberger Balance Due: 47.00 Invoice# 378941 Balance Due: / 282.00 PLEASE REMIT PAYMENT PROMPTLY _ Cut and return withQayment_ 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 4/3/14 378941 Pre-employment drug testing $ 188.00 4/3/14 378941 Pre-employment drug testing $ 94.00 I 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 INVOICE NO. ACCT#/TITL AMOUNT Board Members Dept# 1081-99 378941 4340700 $ 188.00 1 hereby certify that the attached invoice(s), or 1082-99 378941 4340700 $ 94.00 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 17-Apr 2014 $ 282.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund