HomeMy WebLinkAbout232478 05/13/14 ('�'""� CITY OF CARMEL, INDIANA VENDOR: 355031
s ONE CIVIC SQUARE COMMUNITY OCCUPATIONAL HEALTH���OK AMOUNT: $*******141.00*
s. _� CARMEL, INDIANA 46032 7169 SOLUTION CENTER CHECK NUMBER: 232478
9M�(��N � CHICAGO IL 60677-7001 CHECK DATE: 05/13/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4340700 381312 141.00 MEDICAL FEES
Community Occupational Health Svs
7169 Solution Center
Chicago, IL 60677-7001
Phone: 317-621-0341
FEIN: 35-1955223 A PR'2 12014
Invoice
April 16, 2014
Bill to: Lynn Russell For: Carmel Clay Parks &Recreation
Cannel Clay Parks &Recreation 4/14
1411 E. I I 6th St.
Carmel, IN 46032-
.............-'--1-11.1_-1--1_-------- ............... ...................---------------..........
Invoice 381312
..........
Proc Code Date Description Qiy Charge Receil) AdMus-t Balance
746404 04/04/2014 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Blake 0 Barlow Balance Due: 47.00
746404 04/08/2014 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Victoria L Bonebright Balance Due: 47.00
746404* 04/08/2014, Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Andrew T Fritz Balance Due: 47.00
Invoice# 381312 Balance Due: 141.00
Purchas C b PLEASE REMIT PAYMENT PROMPTLY
Description
P.O.# P or F
G.L.#
T7_7
Budaet
Une-bes
Purchaso --ALAI
Approval Date_
Cut and return witil-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
4/16/14 381312 Pre-employment drug testing $ 141.00
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
108 ESE
i
PO-11 or Board Members
Dept# INVOICE NO. ACCT#/TITL AMOUNT
1081-99 381312 4340700 $ 141.00 j. 1 hereby certify that the attached invoice(s), or
bill(s) is(are)true and correct and that the
i
materials or services itemized thereon for
which charge is made were ordered and
received except
i
l
8-May 2014
I
I
$ 141.00 ` Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
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