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Home My WebLink About234256 07/01/2014i �` "MF. - CITY OF CARMEL, INDIANA VENDOR: 355031 ® ONE CIVIC SQUARE COMMUNITY OCCUPATIONAL HEALTH PaldkOK AMOUNT: $*******274.00* i° CARMEL, INDIANA 46032 7169 SOLUTION CENTER CHECK NUMBER: 234256 M�jON,�p` CHICAGO IL 60677-7001 CHECK DATE: 07/01114 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1110 4341999 386641 47.00 OTHER PROFESSIONAL FE 2201 4239099 387448 98.00 OTHER MISCELLANOUS 651 5023990 388170 129.,00 OTHER EXPENSES Community Occupational Health Svs 7169 Solution Center Chicago, IL 60677-7001 Phone: 317-621-0341 FEIN: 35-1955223 Invoice June 16, 2014 Bill to: Jim Spelbring For: Carmel Street Dept. Cannel Street Dept. 6/14 I Civic Square Cannel, IN 46032- Invoice# 387448 Proc Code Date Description QtV Charge Receipt Adjust Balance 06/04/2014 Respirator Fit Test 1.00 49.00 49.00 Evie M Anderson XXX-XX-7323 Balance Due: 49.00 06/04/2014 Respirator Fit Test 1.00 49.00 49.00 Lynette A Hobbs XXX-XX-2503 Balance Due: 49.00 Invoice# 387448 Balance Due: 98.00 PLEASE REMIT PAYMENT PROMPTLY ....-Cut and return with payment 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)) 06/16/14 $98.00 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. 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 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 V UVAIVY Street ComrrftdageDune 27, 2014 Street Commissioner Title Cost distribution ledger classification if claim paid motor vehicle highway fund Community Occupational Health Svs 7169 Solution Center Chicago, IL 60677-7001 Phone: 317-621-0341 FEIN: 35-1955223 Invoice June 03, 2014 Bill to: Jim Spellbring For: Cannel Police Department Cannel Police Department 5/14 1 Civic Square Cannel, IN 46032- _......................._.................... . ........._...._. _...._..v._.........................._.._...._......._.............................._........... ........................................... Invoice# 386641 Proc Code Date Description Qty Charge Receipt Adjust Balance 30101 05/28/2014 NON-NIDA 5 Panel UDS 1.00 47.00 47.00 George W Davis XXX-XX-9260 Balance Due: 47.00 Invoice# 386641 Balance Due: 47.00 PLEASE REMIT PAYMENT PROMPTLY 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)) 06/03/14 386641 employee blood draw $47.00 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. ALLOWED 20 Community Occupational Health Services IN SUM OF $ 7169 Solution Center Chicago, IL 60677-7001 $47.00 ON ACCOUNT OF APPROPRIATION FOR Carmel Police Department PO#/Dept. INVOICE NO. ACCT#!TITLE AMOUNT Board Members 1110 I 386641 I 43-419.99 I $47.00 f 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 Thursday, June 26, 2014 Chief of Police Title Cost distribution ledger classification if claim paid motor vehicle highway fund Community Occupational Health Svs 7169 Solution Center Chicago, IL 60677-7001 Phone: 317-621-0341 FEIN: 35-1955223 Invoice June 16, 2014 Bill to: Jim Spelbring For: Cannel Utilities Cannel Utilities 6/14 1 Civic Square Carmel, IN 46032- Invoice# 388170 Proc Code Date Description Qty Charge Receipt Adiust Balance 06/12/2014 Whisper Test 1.00 8.00 8.00 747920 06/12/2014 DOT Urine Drug Screen 1.00 50.00 50.00 81002 06/12/2014 Urinalysis,Mini Dip w/Physical 1.00 8.00 8.00 99173 06/12/2014 Snellen 1.00 8.00 8.00 99386 06/12/2014 DOT/PPCL Exam 1.00 55.00 55.00 Anthony M Harvey XXX-XX-9880 Balance Due: 129.00 Invoice# 388170 Balance Due: 129.00 PLEASE REMIT PAYMENT PROMPTLY Cut and return with payment -- - ------------------- Please remit 129.00 to Community Occupational Health Services 7169 Solution Center - — Please place invoice number 388170 on check Chicago, IL 60677-7001 Phone: 317-621-0341 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 of service rendered, by whom, rates per day, number of units, price per unit, etc. Payee 355031 COMMUNITY OCCUPATIONAL HEALTH Purchase Order No. 7169 Solution Center Terms Chicago, IL 60677-7001 Due Date 6/25/2014 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 6/25/2014 388170 $129.00 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 Date Officer VOUCHER # 138294 WARRANT # ALLOWED 355031 IN SUM OF $ COMMUNITY OCCUPATIONAL HEALTI 7169 Solution Center Chicago, IL 60677-7001 Carmel Wastewater Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO# INV# ACCT# AMOUNT Audit Trail Code 388170 01-7752-05 $129.00 Voucher Total $129.00 Cost distribution ledger classification if claim paid under vehicle highway fund