HomeMy WebLinkAbout231740 4/23/2014 tq -
'. CITY OF CARMEL, INDIANA VENDOR: 367222
i. ONE CIVIC SQUARE IU HEALTH WORKPLACE SERVICES LLCCHECK AMOUNT: $"'*"1,009.00"`
CARMEL, INDIANA 46032 2046 RELIABLE PKWY CHECK NUMBER: 231740
CHICAGO IL 60686-0020 CHECK DATE: 04/23/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1201 4358800 733165 1,009.00 TESTING FEES
,Jc ,w Indiana University Health Workplace Services, LLC
---- 950 North Meridian Street
12�\ Suite 200 (City of Carmel) '�����ffii> t�
Indianapolis, IN 46204 To
Phone: 317-963-1534
FEIN: 20-0994452 APR 2 12014
Ct"Pk T rellsurer
Invoice
�. April 01, 2014
Bill to: Barbara Lamb For: City of Carmel -Onsite
City of Carmel -Onsite Onsite/March 2014
1 Civic Square
Carmel,IN 46032-
' _.._. ... __._..__.�._.. . . _...___.___._...,.._____...__..._._._. _._..__.._............. ..._..._._._.__._.__ . .._..�.._..__...... ._..._._____._... ..... _.._...w.__ .... ... ______......
Invoice# 733165
Proc Code Date Description
15.00
kit
Invoice# 733165 (continued)page 2
15.00
kit
15.00
Invoice# 733165 (continued)page 3
03/25/2014 Quick Read UDS/6panel includes 1.00 15.00 15.00
kit
15.00
kit
15.00
kit
Invoice# 733165 (continued)page 4
15.00
I
Invoice# 733165 (continued)page 5
03/21/2014 Quick Read UDS/6panel includes
15.00
kit
15.00
i
Invoice# 733165 (continued)page 6
Invoice 9 733165 Balance Due: 1009.00
MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE
DATE- PLEASE INCLUDE INVOICE#ON CHECK
I
I
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))
04/01/14 733165 Onsite March $1,009.00
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
IU Health Workplace Services, LLC
IN SUM OF $
2046 Reliable Pkwy
Chicago, IL 60686-0020
$1,009.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel HR Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1201 I 733165 I 43-588.00 I $1,009.00 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
Monday, April 21, 2014
Director, HR
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund