The URL can be used to link to this page

Home My WebLink About236346 08/27/14 coq. �' ,,,f CITY OF CARMEL, INDIANA VENDOR: 355031 1 ® ONE CIVIC SQUARE COMMUNITY OCCUPATIONAL HEALTH lgldROK AMOUNT: $ 458.00' ;, � CARMEL, INDIANA 46032 7169 SOLUTION CENTER CHECK NUMBER: 236346 9M1.oN�. CHICAGO IL 60677-7001 CHECK DATE: 08/27/14 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 651 5023990 391998 129.00 OTHER EXPENSES 1081 4340700 392255 329.00 MEDICAL FEES Community Occupational Health Svs 7169 Solution Center Purchase �icago, IL 60677-7001 na ty hone: 317-621-0341 n Doscriptio � P.O.# P or Fri FEIN: 35-1955223 0 �� ' - V-3 070D �_3 9. 00 ECL ITE t'JU ,, ,9 u �lescr� 4—ev �j �e J/L AUG - 6 7014 P.;rchas . �.. ✓ // Approv..l -L. --- Z ��y Invoice .; August 01 , 2014 Bill to: Lynn Russell For: Cannel Clay Parks & Recreation Cannel Clay Parks & Recreation 7/14 1411 E. 116th St. Cannel, IN 46032- Invoice # 392255 Proc Code Date Description QtV Charge Receipt Adiust Balance 746404 07/31/2014 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Elise A Avagian Balance Due: 5 47.00 746404 07/31/2014 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Chelsea N Bolton Balance Due: 5 47.00 746404 07/30/2014 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Andre T Broadnax Balance Due: S, 47.00 746404 07/31/2014 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Sarah R Chamberlain Balance Due: S 47.00 746404 07/30/2014 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Sherri L Lang Balance Due: S 47.00 746404 07/24/2014 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Megan N Poteet Balance Due: S 47.00 746404 07/30/2014 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Michael A Sanborn Balance Due: 5 47.00 Invoice# 392255 Balance Due: 329.00 PLEASE REMIT PAYMENT PROMPTLY Cut and retum with payment Q-. - ------------------------------- ------------------ 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 8/1/14 392255 Pre-employment drug testing $ 329.00 I Total $ 329.00 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 Voucher No. Warrant No. 355031 .Community Occupational Health Services Allowed 20 7169 Solution Center Chicago, IL 60677-7001 In Sum of$ $ 329.00 ON ACCOUNT OF APPROPRIATION FOR 108 -ESE PO#orBoard Members Dept# INVOICE NO. CCT#/TITL AMOUNT 1081-99 392255 4340700 $ 329.00 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 21-Aug 2014 $ 329.00 Accounts Payable Coordinator Cost distribution ledger classification if Title 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 August 01, 2014 Bill to: Jim Spelbring For: Cannel Utilities Cannel Utilities 7/14 1 Civic Square Cannel, IN 46032- Invoice# 391998 Proc Code Date Description QtV Charge Receipt Adjust Balance 07/21/2014 Whisper Test 1.00 8.00 8.00 747920 07/21/2014 DOT Urine Drug Screen 1.00 50.00 50.00 S1002 07/21/2014 Urinalysis,Mini Dip w/Physical 1.00 8.00 8.00 99173 07/21/2014 Snellen 1.00 8.00 8.00 99386 07/21/2014 DOT/PPCL Exam 1.00 55.00 55.00 Hani Y Soueidan XXX-XX-7826 Balance Due: 129.00 Invoice# 391998 Balance Due: 129.00 PLEASE REMIT PAYMENT PROMPTLY 05 � I Cut and return with payment �"-- ------------ ---- --- czy— Please remit 129.00 to Community Occupational-Health Services 7169 Solution Center Please place invoice number 391998 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 8/19/2014 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 8/19/2014 391998 $129.00 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 Date icer VOUCHER # 145350 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 391998 01-7752-05 $129.00 Voucher Total $129.00 Cost distribution ledger classification if claim paid under vehicle highway fund