Loading...
HomeMy WebLinkAbout246255 06/1 7/1 5 a u.c�AM �/ � CITY OF CARMEL, INDIANA VENDOR: 355031 J ONE CIVIC SQUARE COMMUNITY OCCUPATIONAL HEALTH%kjA9K AMOUNT: 5*""""2,068.00" 9� � CARMEL, INDIANA 46032 CHICAGO S SOLUTION ION CENTER 7001 CHECK NUMBER: 246255 M,tfoN CHECK DATE: 06/17/15 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1082 4340700 418651 188.00 415909 1082 4340700 418651 987.00 419870 1082 4340700 418651 893.00 MEDICAL FEES Community Occupational Health Svs - 7169 Solution Center Chicago, IL 60677-7001 Phone: 317-621-0341 FEIN: 35-1955223EJUN - r 2015 1 Invoice April 16, 2015 Bill to: Lynn Russell For: Carmel Clay Parks &Recreation Carmel Clay Parks &Recreation 04/15 1411 E. 116th St. Carmel, IN 46032- Invoice# 415909 Proc Code ICD9 Date Description Qty Change Receipt Adjust Balance 746404 04/10/2015 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Christie M Cudney Balance Due: 47.00 746404 04/03/2015 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Matthew A Gregory Balance Due: 47.00 746404 04/14/2015 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Jeimmy Y GumbusSoto Balance Due: 47.00 746404 1)847.1 04/07/2015 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 2)E927.0 Justin S Hardcastle Balance Due: 47.00 Invoice# 415909 Balance Due: 188.00 PLEASE REMIT PAYMENT PROMPTLY '7--* 9 E Purchase Description P.O.# PorF G.L.# Budget Line Descr Purchaser Date Approval Date O_ Cut and return with payment r'' Community Occupational Health Svs * 7169 Solution Center Purchase Chicago, IL 60677-7001 MAY 2 2 2015 '� Description Phone: 317-621-0341 P.O.# P°r F FEIN: 35-1955223 BY: Budget � C Line Descr Ir f Purchas to Approval Date Invoice May 15, 2015 Bill to: Lynn Russell For: Carmel Clay Parks &Recreation Carmel Clay Parks &Recreation 05115 1411 E. 116th St. Carmel, IN 46032- ___._...._....__.._._......_._ __..._..._._...___.....___.__._.._.___ ___.____.____..__..._..........._._._.._.._._.._.____ _.________._.__._._ __ __.._______.__._.._..._.._.__....._._._._..__.._._._.__. Invoice# 418651 Proc Code Date Description Qty Charge Receipt Adiust Balance 746404. 05/12/2015 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Katlynn Boxell Balance Due: 47.00 746404 05/12/2015 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Kyla M Breland Balance Due: 47.00 746404 05/05/2015 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Megan E Carr Balance Due: 47.00 746404 05/11/2015 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Kevin M Fleming Balance Due: 47.00 746404 05/11/2015 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Dedric D Griffin Balance Due: 47.00 746404 05/12/2015 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Mary Habig Balance Due: 47.00 746404 05/06/2015 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Jessica R Hanes Balance Due: 47.00 746404 05/13/2015 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Alexis Higgins Balance Due: 47.00 746404 05/11/2015 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Jancyn C Hill Balance Due: 47.00 746404 05/02/2015 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Zachary T Kogler Balance Due: 47.00 746404 05/11/2015 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Leah M Milliken Balance Due: 47.00 746404 05/10/2015 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Invoice# 418651 (continued)page 2 _.. '.. ........_.................._..............._... __..._......._._......................__._.._..._..._...__......._...._..._.._..._._............._..... ...._._.._...._........._._..__..._...._....._..__...................._:._...__..__........................_................._..............__._.........................._:..._.._._._... _._. Lucy E Moreman Balance Due: 47.00 746404 05/08/2015 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Elise J Morfas Balance Due: 47.00 746404 05/12/2015 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Matthew J Olson Balance Due: 47.00 746404 05/11/2015 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Megan F Resener Balance Due: 47.00 746404 11 2 - OS/ / 015 Drug Screen Non NIDA 5 Panel 1.00 47.00 47.00 Shannon E Roberts Balance Due: 47.00 746404 05/11/2015 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Kayla L Walker Balance Due: 47.00 746404 05/11/2015 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Melissa M Zielinski Balance Due: 47.00 746404 05/08/2015 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Nadia L Zimmerman Balance Due: 47.00 Invoice# 418651 Balance Due: 893.00 PLEASE REMIT PAYMENT PROMPTLY �� Cut and return with payment Community Occupational Health Svs a 7169 Solution Center Chicago, IL 60677-7001 Phone: 317-621-0341 FEIN: 35-1955223 ��-� '� JUN -8 2015 �' : Invoice ------ June 02, 2015 Bill to: Lynn Russell For: Carmel Clay Parks &Recreation Carmel Clay Parks &Recreation 05115 1411 E. 116th St. Carmel, IN 46032- Invoice# 419870 Proc Code Date Description 9-ty Charge Receipt Adjust Balance 746404 05/18/2015 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Blake T Adams Balance Due: 47.00 _....__.._....__....__.........................._.._.........._..._...._....._._...................._..._......_...._.... 746404 05/16/2015 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Anna M Atkinson Balance Due: 47.00 ........................................_.........._.............._........................................----...... ......._.._.._...................................................._...................................... 746404 05/14/2015 Drug Screen-Non NIDA 5 Panel 1.00 47.00 4.7.00 Jonathan G Balland Balance Due: 47.00 746404 05/08/2015 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Jessica A Bookout Balance Due: 47.00 _......................._._.._......._........._....._..............._...._............__.................... 746404 05/16/2015 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Kathryn A Bradberry Balance Due: 47.00 _................................_......._................................_...__..............................._......_.._..................__......_............................_.... 746404 05/14/2015 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Courtney Christl Balance Due: 47.00 746404 05/15/2015 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Christopher B Deputy Balance Due: 47.00 .................... ......... ..... ._...__.... .._. ._. ._._...._...__.......__ ...... __...... ........__.... 746404 05/08/2015 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Margaret C Duxbury Balance Due: 47.00 746404 05/14/2015 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Mitchell L Greene Balance Due: 47.00 746404 05/16/2015 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Sara C Highers Balance Due: 47.00 ------------... 746404 05/21/2015 Drug ......_.........._......_.._............. Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Nicholas J Jakupco Balance Due: 47.00 ..........._..._.._.._.......................... ............................................._...._.......................__.........._...... .............._............................_.. 746404 05/29/2015 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 L,g Lbu-."r) Invoice# 419870 (continued)page 2 ----------- Janet C Karsas Balance Due: 47.00 746404 05/14/2015 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Reese Kavanaugh Balance Due: 47.00 746404 05/20/2015 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Adeline C Lange Balance Due: 47.00 ...............--- ................ ................................. ...... 746404 05/05/2015 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Jennifer Lavely Balance Due: 47.00 .....................................I.................................................................... 746404 05/22/2015 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Melissa Liebner Balance Due: 47.00 746404- 05/20/2015 Drug Screen-Non NIDA 5 Panel 1.00 -47.00 ---:4-7.00 Sarah M Pachmayer Balance Due: 47.00 746404 05/20/2015 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 1 Nicole L Parks Balance Due: 47.00 ............... ......I.......I.............. .. ..... ............................... 746404 05/14/2015 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Linnea N Peters Balance Due: 47.00 ........... .................. ......... .............. ................ ..................I....... 746404 05/08/2015 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Samuel A Philleo Balance Due: 47.00 746404 05/14/2015 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Jessica C Schuch Balance Due: 47.00 .............................. Invoice# 419870 Balance Due: 987.00 PLEASE REMIT PAYMENT PROMPTLY PUMIIRSO Description P.O.# P or F G.L.9 Bt--daei, una"beso Purchase, Date- Approval Date- Cut and return with payment ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice of bill to be property 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 5/15/15 418651 Pre-employment drug testing $ 893.00 ., 4116/15 -415909 Pre=erriployment-drug testing _ _ $ 47.00 4/16/15 415909 Pre-employment drug testing $ 141:00 --- - 6/2/15 419870 Pre-employment drug testing $ 987.00 Total $ 2,068.00 I hereby certify that the attached invoice(s),or bill(s)is(are)true and correct and I have audited same in accordance with I C 5-11-10-1.6 , 20 Clerk-Treasurer I Voucher No. Warrant No. 355031 Community Occupational Health Services Allowed 20' 7169 Solution Center Chicago, IL 60677-7001 In Sum of'$ $ 2,068.00 " ON ACCOUNT OF APPROPRIATION FOR 108 ESE/109 Monon Center' PO#or INVOICE NO. CCT#/TITL AMOUNT Board Members Dept# 1082-99 4,18651 _ 4340700 $ 893.00 1 hereby certify that the attached invoice(s), or . 1092 415909 4340700, $ 47.00, bill(s)is(are)true and correct and that the 1082-99 415909 4340700 $ 141.00 . materials or services itemized thereon'for 1082-99_ 419870 4340700.. $ 987.00 which charge is made were ordered and „ . I received except I 1 June 1 1, 2015 I. $ .2,068.00 . Accounts Payable Coordinator.. Cost distribution ledger classification if Title, claim paid motor vehicle highway fund