HomeMy WebLinkAbout234813 07/16/14 `� �Qp''F CITY OF CARMEL, INDIANA VENDOR: 355031
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'; ® ij ONE CIVIC SQUARE COMMUNITY OCCUPATIONAL HEALTHQtIROK AMOUNT: $"'""`"47.00•
v i° CARMEL, INDIANA 46032 7169 SOLUTION CENTER CHECK NUMBER: 234813
9Miton�o` CHICAGO IL 60677-7001 CHECK DATE: 07/16/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4341999 389149 47.00 OTHER PROFESSIONAL FE
Community Occupational Health Svs
7169 Solution Center
Chicago, IL 60677-7001
Phone: 317-621-0341
FEIN: 35-1955223
Invoice
July 02, 2014
Bill to: Jim Spellbring For: Carmel Police Department
Carmel Police Department 6/14
1 Civic Square
Carmel, IN 46032-
Invoice# 389149
Proc Code Date Description QtV Charge Receipt Adjust Balance
80101 06/18/2014 NON-NIDA 5 Panel UDS 1.00 47.00 47.00
Steven Cash XXX-XX- Balance Due: 47.00
Invoice# 389149 Balance Due: 47.00
PLEASE REMIT PAYMENT PROMPTLY -
Cut and return with payment
VOUCHER NO. WARRANT NO.
ALLOWED 20
Community Occupational Health Services
IN SUM OF$
7169 Solution Center
Chicago, IL 60677-7001
$47.00
i
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1110 389149 43-419.99 $47.00 I 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
Friday, July 11, 2014
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
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))
07/02/14 389149 blood draw-Officer Cash $47.00
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