The URL can be used to link to this page

Home My WebLink About256280 03/15/16 t�, CITY OF CARMEL, INDIANA VENDOR: 355031 ® ONE CIVIC SQUARE COMMUNITY OCCUPATIONAL HEALTH%tIrtOK AMOUNT: $******"595.00' :.. ;_� CARMEL, INDIANA 46032 7169 SOLUTION CENTER CHECK NUMBER: 256280 9M,«oN�. CHICAGO IL 60677-7001 CHECK DATE: 03/15/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1081 4340700 442730 188.00 MEDICAL FEES 1125 4340700 442730 78.00 MEDICAL FEES 1081 4340700 446857 329.00 MEDICAL FEES r Voucher No. Warrant No. 355031 Community Occupational Health Services Allowed 20 7169 Solution Center Chicago, IL 60677-7001 In Sum of$ i $ 595.00 ON ACCOUNT OF APPROPRIATION FOR 101 General Fund 1108 ESE PO#or INVOICE NO. ACCT#/TITL AMOUNT Board Members Dept# 1125 442730 4340700 $ 78.00 1 hereby certify that the attached invoice(s), or 1081-99 442730 4340700 $ 188.00 bill(s) is (are)true and correct and that the 1081-99 446857 4340700 $ 329.00 materials or services itemized thereon for which charge is made were ordered and received except March 10, 2016 Signature $ 595.00 , Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund I I 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 1/18/16 442730 Pre-employment drug testing $ 78.00 1/18/16--:_ 44273Q- - , Pre-employment drug testing $ 188.00 3/2/16 - 446857 Pre-employment drug testing $ 329.00 Total $ 595.00 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 CorrlrnunitjOccapatonal&Fiealhf Svs h" ,Center,,w Chicago, IL�160677_=700 �`Fhone;1:31;7�-62:1_-0:3.41r-� _-_— FEIN: 35-1955223 E MAR 0 9 2016 BY: Inoices Janua Bill to: Lynn Russell For: Carmel Clay Parks &Recreation Carmel Clay Parks &Recreation 01/16 1411 E. 116th St. Carmel, IN 46032- In�o>c�� ;2442730 ', Proc Code ICD Date Description QtV Charge Receipt Adiust Balance 746404 01/13/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 82075 01/13/2016 Breath Alcohol Test 1.00 31.00 31.00 John Aleksa Balance Due: 78.00 746404 1) 01/08/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 S40.021 A 2) Y08.89XA Audrey A Cooper Balance Due: 47.00 746404 1) 01/08/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 550.81 I A 2) Y08.89XA Eden Gill Balance Due: 47.00 746404 01/06/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Kaitlin M Robinson Balance Due: 47.00 746404 01/09/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Nicole Sullivan Balance Due: 47.00 ,'-7',. y.x y-��a s�:ayr=FTS b� >.Yak 'G-h't�vta t ,y.�r. nvoice- 442 j3Q Balance Due 5� ��266�:Q0� PLEASE REMIT PAYMENT PROMPTLY AT '- ST DUE 3-q C Cornmunitffis)ccupatiomahHealthSus E TV END Center Chicago;4IL 6067&7-7001 MAR 07 2016 Phorie 317:-621 0341 , ,5 chase FEIN:35-1955223 e=scription BY: - P.O.# P or F G.L.# Iludret Line Descr Invoice Purchaser Date Approval Date March.02, 201' Bill to: Lynn Russell For: Carmel Clay Parks & Recreation Carmel Clay Parks &Recreation 02/16 1411 E. 116th St. Carmel, IN 46032- InuoiceY# Proc Code ICD Date Description Qtv Charge Receipt Adjust Balance 746404 02/18/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Becky S Barker Balance Due: 47.00 746404 02/25/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00: 47.00 - - - -Nadyne A-Brookshire Balance-Due: -47.00 746404 02/25/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Alexis Derbique Balance Due: 47.OQ 746404 02/18/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Samantha J Hamilton Balance Due: 47.00 746404 1) 02/16/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 580.11 XA 2) W 50.1 XX A Lucille Jones Balance Due:- 47.00,- - 746404 7.00.--746404 02/25/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Leonid Melnikov Balance Due: 47.00 746404 02/18/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Jacob E Norris Balance Due: 47.00 Invoice# 446857 Balance Due: 29.00 3_� 11 PLEASE REMIT PAYMENT PROMPTLY -