HomeMy WebLinkAbout257681 04/22/16 0�T`/ CITY OF CARMEL, INDIANA VENDOR: 355031
ONE CIVIC SQUARE COMMUNITY OCCUPATIONAL HEALTH CUROK AMOUNT: $*******282.00*
r =Q CARMEL, INDIANA 46032 7169 SOLUTION CENTER CHECK NUMBER: 257681
9.1j��T0el�`0 CHICAGO IL 60677-7001 CHECK DATE: 04/22/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4340700 449680 282.00 MEDICAL FEES
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
4/4/16 449680 Pre-Employment Drug Testing $ 282.00
Total $ 282.00
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$
$ 282.00
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1081-99 449680 4340700 $ 282.00 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
April 12, 2016
Signature
$ 282.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
CdffM,` unity-'Occ p nal-Health Svs
7169 Solution a�Gen"ter,
Chicago, IL 46067,7.-7001
Phone X3171621 0341
FEIN: 35-1955223 RECEIVED
D
APR - 7 2016
B :
lnuoice.
Aprl_0;4;�20r6
Bill to: Lynn Russell For: Carmel Clay Parks &Recreation
Carmel Clay Parks &Recreation 03/16
1411 E. 116th St.
Carmel, IN 46032-
Invoice-## 449680
Proc Code Date Description QtV Charge Receipt Adjust Balance
746404 03/15/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Kiya D Eldridge Balance Due: 47.00
746404 03/24/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 . 47.00
Grant Fellabaum Balance Due: 47.00
746404 03/24/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Riley A Leonard Balance Due: 47.00
._...__ ............................. ..... ... . .. ...................................... ......................
.
746404 03/18/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
- Nicole L Parks Balance Due: 47.00
_._................................................................................___........_........_._..
746404 03/16/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Natalie F Rumreich Balance Due: 47.00
............._..._.:.._.................._.._,._.................. _..__...............
746404 03/24/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Sharron E Ward Balance Due: 47.00
Invoice# 449680 Balance Due: 282:00
PLEASE REMIT PAYMENT PROMPTLY
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