HomeMy WebLinkAbout249214 09/09/15 oi.
CITY OF CARMEL, INDIANA VENDOR: 355031
ONE CIVIC SQUARE COMMUNITY OCCUPATIONAL HEALTH%ldf QK AMOUNT: $*******282.00*
CARMEL, INDIANA 46032 7169 SOLUTION CENTER CHECK NUMBER: 249214
CHICAGO IL 60677-7001 CHECK DATE: 09/09/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1082 4340700 427630 282.00 MEDICAL FEES
Community Occupational Health Sva
7169Solution Center
Chicago, IL 80077'7001
Phone: 317'021'0341
FEIN: 35'1955223
AUG 24 Z015 Invoice
August 17. 2015
Bill to: Lynn Kuaoc|l For: CuoocJ Clay Parks & Recreation
C000c] Clay Parks & Recreation 8-15
1411 E. )l6th St.
Cannel, IN 40O32-
luvoicc # 427630
| ------ ---- '--------- - -Proc Code Code Date Description QtV Charge Receip Balance
740404 08N2/2015 Drug Screen Non NIDA 5yund 1.00 47.00 47.00
-------
Alcna Bu,d,y Balance Nuc: 47.00
740404 08/13/2015 Drug Screen'Non NIDA 5Pund 1.00 47.00 47.00
----------
Katie JBrackett Boluncx Due: 47.00
746404 08/05/2015 Drug Screen'Non NIDA 5 Panel 1.00 47.00 47.00
----------
Andrew% Gottschalk Boluuro Due: 47.00
746404 08/05/2015 Drug Screen Non NIDA 5Panel 1.00 47.00 47.00
----------
Jcuoeo PJuc�or Bo)uucc o' 47.00
80101 08/04/2015 NON'NIDA jPanel UDS 1.00 47.00 47.00
Mu|iu M M ��uuucm Due:l D -------
ou,nu 47.00
746404 08/01/2015 Drug Screen'Non NIDA 5Panel 1.00 47.00 47.00
----------
Jonathan Y0 dmvo0 luuxx muc/ 47.00 �
| ----------
Iuvoico# 4I7630Balance Due: 282.00
PLEASE REMIT PAYMENT PROMPTLY
AUG Z 4 2015 Ly /l
Cut and return with paymmt
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
8/17/15 427630 Pre-employment drug testing $ 282.00
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
Voucher No. Warrant No.
355031 Community Occupational Health Services Allowed 20
7169 Solution Center
Chicago, IL 60677-7001
In Sum of$
$ 282.00
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1082-99 427630 4340700 $ 282.00 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
i
September 8, 2015
$ 282.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund