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HomeMy WebLinkAbout256103 03/04/16 ('�`p4•. CITY OF CARMEL, INDIANA VENDOR: 355031 �• ONE CIVIC SQUARE COMMUNITY OCCUPATIONAL HEALTH(UR4K AMOUNT: $*******141.00' r ?a CARMEL, INDIANA 46032 7169 SOLUTION CENTER CHECK NUMBER: 256103 CHICAGO IL 60677-7001 CHECK DATE: 03/04/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1081 4340700 445650 141.00 MEDICAL FEES Voucher No. Warrant No. ! I 355031 Community Occupational Health Servi�es Allowed 20 7169 Solution Center Chicago, IL 60677-7001 In Sum of$ $ 141.00 i ON ACCOUNT OF APPROPRIATION FOR I 108 ESE i i I PO#or INVOICE NO. ACCT#/TITLE AMOUNT I Board Members Dept# 1081-99 445650 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 i received except i I February 22, 2016 1 Signature $ 141.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund 1 CoppmnityrOccuptio�al3Health�Su�s' 71.69$olution Center � � agog IL 60�67�7c=70Q1 10 Phone 317 62�i1 41 FEIN: 35-1955223 AWKNW C �i Febr ary1;6, �ZOx16h Bill to: Lynn Russell For: Carmel Clay Parks & Recreation Cannel Clay Parks &Recreation 02/16 1411 E. 116th St. Cannel, IN 46032- Ifivotce"�# 4"4�6�� Proc Code Date Description QtV Charge Receipt Adiust Balance 746404 02/11/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Lesley A Bonds Balance Due: 47.00 746404 02/04/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Shea Hurst Balance Due: 47.00 746404 02/11/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Logan S Niccum Balance Due: 47.00 Inuoice# 445650 Balance Due: 1r4+100 PLEASE REMIT PAYMENT PROMPTLY Purchase Description P.O.# PorF G.L.# Budget Lina Descr Purchaser Date Approval Date