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Home My WebLink About251949 12/02/15 u ��q �' "' CITY OF CARMEL, INDIANA VENDOR: 355031 ONE CIVIC SQUARE COMMUNITY OCCUPATIONAL HEALTH PaldROK AMOUNT: $*******752.00* :• ?Q CARMEL, INDIANA 46032 7169 SOLUTION CENTER CHECK NUMBER: 251949 �,;,�roN.�.` CHICAGO IL 60677-7001 CHECK DATE: 12/02/15 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1091 4340700 434830 376.00 MEDICAL FEES 1125 4340700 434830 47.00 MEDICAL FEES 1081 4340700 437467 329.00 MEDICAL FEES 9 ;� Community Occupational Health Svs Purchase " 7169 Solution Center Description Chicago, IL 60677-7001 P.O.# P or F Phone: 317-621-0341 G.L.# FEIN: 35-1955223 i�� ' uaaet NOV -- g 2015 Line Descr Purchaser Date BY. Approval Date Invoice November 03, 2015 Bill to: Lynn Russell For: Cannel Clay Parks & Recreation Cannel Clay Parks & Recreation 10/15 1411 E. 116th St. Cannel, IN 46032- _._.. _.._.... ..__._.._ . Invoice# 434830 Proc Code Date Description Qty_ Charge Receipt Alig Balance 746404 10/21/2015 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Caroline Boyer Balance Due: 47.00 746404 10/22/2015 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Caroline R Brooks Balance Due: 47.00 746404 10/13/2015 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Allyson A Gonzalez Balance Due: 47.00 746404 10/22/2015 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Annabell Kranz Balance Due-.'; 47.00 746404 10/27/2015 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Eric T Nolan Balance Due: 47.00 746404 10/13/2015 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Alison L Pont Balance Due: 47.00 746404 10/29/2015 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Laura J Toole Balance Due: 47.00 746404 10/20/2015 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Lea A Washington Balance Due: 47.00 746404 10/29/2015 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Neil P Whitehead Balance Due: 47.00 Invoice# 434830 Balance Due: 423.00 PLEASE REMIT PAYMENT PROMPTLY NOV 6 2015 Community Occupational Health Svs 7169 Solution Center Chicago, IL 60677-70011L P11V. _,D Phone: 317-621-0341 FEIN: 35-1955223 NOV 2 0 2015 BY: Invoice November 17, 2015 Bill to: Lynn Russell For: Cannel Clay Parks & Recreation Cannel Clay Parks & Recreation 11115 1411 E. 116th St. Carmel,IN 46032- Invoice# 437467 Proc Code Date Description Qty Charge Receipt Adjust Balance 746404 11/05/2015 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Kara F Anderson Balance Due: 47.00 746404 11/12/2015 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 MaryJo Engle Balance Due: 47.00 746404 11/06/2015 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Joanna Faust Balance Due: 47.00 746404 11/06/2015 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Nathaniel Hillyer Balance Due: 47.00 746404 11/07/2015 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Adam P Kurek Balance Due: 47.00 746404 11/06/2015 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Phillip Maxie Balance Due: 47.00 746404 11/06/2015 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Sherron Wendell Balance Due: 47.00 Invoice# 437467 Balance Due: 329.00 PLEASE REMIT PAYMENT PROMPTLY a0 LLX 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 11/3/15. 434830 Pre-employment drug testing $ 47.00 11/3/15 434830 Pre-employment drug testing $ 376.00 11/17/15 437467 Pre-employment drug testing $ 329.00 Total $ 752.00 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$ $ 752.00 ON ACCOUNT OF APPROPRIATION FOR 101 General /108 ESE PO#orBoard Members Dept# INVOICE NO. CCT#/TITL AMOUNT 1125 434830 4340700 $ 47.00 1 hereby certify that the attached invoice(s), or 1081-99 434830 4340700 $ 376.00 bill(s)is(are)true and correct and that the 1081-99 437467 4340700 $ 329.00 materials or services itemized thereon for which charge is made were ordered and received except November 23, 2015 Signature $ 752.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund