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Home My WebLink About233027 05/28/14 �4Aq <<� f CITY OF CARMEL, INDIANA VENDOR: 355031 ONE CIVIC SQUARE COMMUNITY OCCUPATIONAL HEALTH TMG9K AMOUNT: $*****1,222.00* _� CARMEL, INDIANA 46032 7169 SOLUTION CENTER CHECK NUMBER: 233027 49M��r'os�O� CHICAGO IL 60677-7001 CHECK DATE: 05/28/14 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1081 4340700 382433 235.00 MEDICAL FEES 1082 4340700 382433 235.00 MEDICAL FEES 1081 4340700 384267 235.00 MEDICAL FEES 1082 4340700 384267 517.00 MEDICAL FEES Community Occupational Health Svs 7169 Solution Center hicago, IL 60677-7001 Purchase � �� 4PFEIN: hone: 317-621-0341Description 35-1955223 PorF P.O.# MAY 0 7 2014 Budget �� f J 13Y; Line Descr 't J Purchaser_ Date 5 7 Invoice ate v y3 yo 7o o - -16 a3s,to May 02, 2014 /08a- - �3�0 700- a3S.,,o Bill to: Lynn Russe 19 For: Carmel Clay Parks &Recreation Carmel Clay Parks &Recreation 04/14 1411 E. 116th St. Carmel, IN 46032- Invoice# 382433 Proc Code Date Description Qtv Charge Receipt Adiust Balance 746404 04/30/2014 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Joshua L Copp Balance Due: r 47.00 746404 04/16/2014 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Tabitha M Crittendon Balance Due: 47.00 746404 04/22/2014 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47:00 Cynthia J Fischer Balance Due: G 47.00 746404 04/30/2014 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Tyler Horning Balance Due: f�` 47.00 746404 04/30/2014 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 n - Thomas S Lebin Balance Due: 47.00 746404 04/30/2014 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Lillian D Logar Balance Due: `' 47.00 746404 04/16/2014 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Maha M Maarouf Balance Due: S 47.00 746404 04/18/2014 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Alexia L Ohnemus Balance Due: ' 47.00 746404 04/30/2014 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Hannah S Schmaltz Balance Due: 47.00 746404 04/22/2014 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 r' Victoria M Schuster Balance Due: 47.00 Invoice# 382433 Balance Due: _Z 470.00 PLEASE REMIT PAYMENT PROMPTLY C� J�Community Occupational Health Svs Purchase 7169 Solution Center .Description Chicago, IL 60677-7001 P.O.# P orF Phone: 317-621-0341 aa,, FEIN: 35-1955223 udget � TeSt� Line Descr Purchase Approval Date_ oe Invoice 100-9q- May 15, 2014 l o�a-9�-y3 YO Toa- f57 7 00 Bill to: Lynn Russell For: Carmel Clay Parks &Recreation Carmel Clay Parks &Recreation 5/14 1411 E. 116th St. Carmel, IN 46032- Invoice# 384267 Proc Code Date Description QtV Charge Receipt Adiust Balance 746404 05/05/2014 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Robert C Bowers Balance Due: S 47.00 746404 05/13/2014 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Madison A Brake Balance Due: C_ 47.00 746404 05/13/2014 Drug Screen-Non NIDA 5 Panel 1:00 47.00 47.00 Megan Burge,Balance Due: S 47.00 746404 05/08/2014 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Megan E Faulkner Balance Due: S 47.00 746404 05/02/2014 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Kevin M Fleming Balance Due: (2- 47.00 746404 05/08/2014 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Jessica R Hanes Balance Due: 47.00 746404 05/12/2014 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Benjamin N Hatfield Balance Due: L 47.00 746404 05/10/2014 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Brittany Jurgens Balance Due: 47.00 746404 05/12/2014 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Janet C Karsas Balance Due: L' 47.00 746404 05/05/2014 Drug Screen:-Non NIDA 5.Panel 1:00 47.00 47.00. Matthew W Petersen Balance Due: 47.00 746404 05/12/2014 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Grace E Pickering Balance Due: 47.00 0- 746404 05/07/2014 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Invoice# 384267 (continued)page 2 Rhonda J Pines Balance Due: 47.00 746404 05/05/2014 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Andrew J Riley Balance Due: 47.00 746404 05/06/2014 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Julia R Rubenstein Balance Due: 47.00 746404 05/10/2014 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Rebekah A Wright Balance Due: 47.00 746404 05/12/2014 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Brighton W Yau Balance Due: 47.00 Invoice# 384267 Balance Due: 752.00' PLEASE REMIT PAYMENT PROMPTLY 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 5/2/14 382433 Pre-employment drug testing $ 235.00 5/2/14 382433 Pre-employment drug testing $ 235.00 5/15/14 384267 Pre-employment drug testing $ 235.00 5/15/14 384267 Pre-employment drug testing $ 517.00 Total $ 1,222.00 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 i 355031 Community Occupational Health Services Allowed 20 7169 Solution Center Chicago, IL 60677-7001 In Sum of$ $ 1,222.00 ON ACCOUNT OF APPROPRIATION FOR i I 108 ESE PO#or Board Members Dept# INVOICE NO. ACCT#/TITLE AMOUNT 1081-99 382433 4340700 $ 235.00 1 hereby certify that the attached invoice(s), or 1082-99 382433 4340700 $ 235.00' bill(s)is (are)true and correct and that the 1081-99 384267 4340700 $ 235.001 materials or services itemized thereon for 1082-99 384267 4340700 $ 517.00 which charge is made were ordered and received except 22-May 2014 1 $ 1,222.00111 Accounts Payable Coordinator Cost distribution ledger classification if I Title claim paid motor vehicle highway fund