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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