HomeMy WebLinkAbout242239 02/17/15 CITY OF CARMEL, INDIANA VENDOR: 355031
® it ONE CIVIC SQUARE COMMUNITY OCCUPATIONAL HEALTH%18ROK AMOUNT: $*******141.00*
CARMEL, INDIANA 46032 7169 SOLUTION CENTER CHECK NUMBER: 242239
•M,,'ON. ` CHICAGO IL 60677-7001 CHECK DATE: 02/17/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4340700 409076 141.00 MEDICAL FEES
Community Occupational Health Svs
7169 Solution Center
Chicago, IL 60677-7001
Phone: 317-621-0341
FEIN: 35-1955223 7BY:-
Invoice
015 `~
February 03, 2015
Bill to: Lynn Russell For: Cannel Clay Parks & Recreation
Cannel Clay Parks & Recreation 1115
1411 E. l 16th St.
Cannel, IN 46032-
_.......,..._..__ ..._......._..........r...... .................... ... .. ..
Invoice# 409076
Proc Code Date Description QtV Charge Receipt Adjust Balance
746404 01/28/2015 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Olivia M Butts Balance Due: 47.00
746404 01/30/2015 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Riley W Castillo Balance Due: 47.00
746404 01/23/2015 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Oluseun M Kayode Balance Due: 47.00
Invoice# 409076 Balance Due: 141.00
PLEASE REMIT PAYMENT PROMPTLY
Purchase
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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
2/3/15 409076 Pre-employment drug testing $ 1.41.00
Total $ 141.00
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.
355031 Community Occupational Health Services Allowed 20
7169 Solution Center
Chicago, IL 60677-7001
In Sum of$
IiI
$ 141.00
i
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1081-99 409076 4340700 $ 141.00 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
February 12, 2015
$ 141.00 Accounts Payable Coordinator
Cost distribution ledger classification if I Title
claim paid motor vehicle highway fund ('
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