HomeMy WebLinkAbout256785 03/29/16 v`� �• CITY OF CARMEL, INDIANA VENDOR: 355031
® ONE CIVIC SQUARE COMMUNITY OCCUPATIONAL HEALTHGtIROK AMOUNT: $*""""""188.00"
�_� CARMEL, INDIANA 46032 7169 SOLUTION CENTER CHECK NUMBER: 256785
y�TON�, CHICAGO IL 60677-7001 CHECK DATE: 03/29/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4340700 448725 188.00 MEDICAL FEES
Voucher No. Warrant No.
i
355031 Community Occupational Health Service O Allowed 20
7169 Solution Center
Chicago, IL 60677-7001
IIn Sum of$
$ 188.00 4
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1081-99 448725 4340700 $ 188.00 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
March 22, 2016
Signature
$ 188.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
1
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
3/15/16 448725 Pre-employment drug testing $ 188.00
Total $ 188.00
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
520
Clerk-Treasurer
CornmunityOccupational;HealthSvs
716 o)u�ttonrCe�ter �
Cfiicagq;�IL�;�60677 7001.,E
"Phone 317-621 0341
FEIN: 35-1955223
``Far?�s C
MAR 2 1 2016
Invoice - �_—_-
Bill to: Lynn Russell For: Carmel Clay Parks &Recreation
Carmel Clay Parks &Recreation 03/16
1411 E. 116th St.
Carmel, IN 46032-
. . . .
- nvoice# 448725 •,
Proc Code Date Description Qty Charge Receipt Adjust Balance
746404 03/11/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Maria Awad Balance Due: 47:00
746404 03/09/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Kennedy A Jefferson Balance Due:- - 47.00
746404 03/05/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Jalon T Lester Balance Due: 47.00
746404 03/09/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Kevin Toney Woods Balance Due: 47.00
Invoice# 448725 Balance Due:
PLEASE REMIT PAYMENT PROMPTLY