HomeMy WebLinkAbout234501 07/08/14 (9)
CITY OF CARMEL, INDIANA VENDOR: 355031
ONE CIVIC SQUARE COMMUNITY OCCUPATIONAL HEALTHSIdRQK AMOUNT: $*******282.00*
CARMEL, INDIANA 46032 7169 SOLIUL ION CENTER
7001 CHECK NUMBER: 234501
CHECK DATE: 07/08/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1082 4340700 387225 235.00 MEDICAL FEES
1091 4340700 387225 47.00 MEDICAL FEES
Community Occupational Health Svs
7169 Solution Center
Purchase IL 60677-7001 7~'rs —,
Description J )\Chicago,Phone: 317-621-0341 �.�!,_, °- 0 —•�
P.O.# P or F FEIN: 35-1955223 JUN 19 2014
udqet
Line Descr �t
Purchase ate
Approval Date!Jn�/ y Invoice
1091 - y3 `/a7oo 00 June 16, 2014
ro�a- 9 9-Y,3 V 700 a �s-,
Bill to: Lynn Russell For: Carmel Clay Parks &Recreation
Carmel Clay Parks &Recreation 6/14
1411 E. 116th St.
Carmel, IN 46032-
Invoice# 387225
_..__.._._....._.._......_....._.........___.._.._- _.___...._....__..._..._...m__.._............ _.._._............._„_................._.............
. ._ _._....._...... - _ _ .....__...._.__....._...._.__._. v. _..._._._..._ _....._..__..._......_ __
Proc Code Date Description 9t( Change Receipt Adiust Balance
746404 06/12/2014 Drug Screen-Non NIDA 5 Panel 1.00 47.00.- 47.00
Eric J Abbenhads Balance Due: ' 47.00
746404 06/03/2014 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Alison Barber Balance Due: 47.00
746404 06/13/2014 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Anne Marie Bessler_Balance Due: �VN 47.00
746404 06/02/2014 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Leonid Melnikov•Balance Due: 47.00
746404 06/05/2014 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Amanda M Schneckloth Balance Due: 47.00
746404 06/11/2014 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Stacey Zimmerman Balance Due: C 47.00
Invoice# 387225 Balance Due: 282.00
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
6/16/14 387225 Pre-employment drug testing $ 47.00
6/16/14 387225 Pre-employment drug testing $ 235.00
Total $ 282.00
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
I
Voucher No. Warrant No. — a,
355031 Community Occupational Health Services Allowed 20
ov edftien GenteF-
In Sum of$
I �
$ 282.00
ON ACCOUNT OF APPROPRIATION FOR
108ESE /109 MCL j
I
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1091 387225 4340700 $ 47.00 1 hereby certify that the attached invoice(s), or
1082-99 387225 4340700 $ 235.00 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
i
3-Jul 2014
I
$ 282.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund