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HomeMy WebLinkAbout258257 05/06/16 J�%���A . CITY OF CARMEL, INDIANA VENDOR: 355031 = ONE CIVIC SQUARE COMMUNITY OCCUPATIONAL HEALTH WAQK AMOUNT: $*******235.00* • `�a;. CARMEL, INDIANA 46032 7169 SOLUTION CENTER CHECK NUMBER: 258257 �.y��TON�°. CHICAGO IL 60677-7001 CHECK DATE: 05/06/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1081 4340700 451454 235.00 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 4/20/16 451454 Pre-Employment Drug Testing $ 235.00 Total $ 235.00 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$ $ 235.00 ON ACCOUNT OF APPROPRIATION FOR 108 ESE PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members Dept# 1081-99 451454 4340700 $ 235.00 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 27, 2016 'PAW"VX" Signature $ 235.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund � A.4 C mmuityOccupationalHoalth Svs 71169 Solution Cerit�e�r �GhicagoylL� N60677:700T �;r��IV ''D Phone.X31'7 621`0341 FEIN: 35-1955223 APR 2 5 2016 Invoice �rApr11-72;0;;2016 ; Bill to: Lynn Russell For: Carmel Clay Parks &Recreation Carmel Clay Parks &Recreation 04/16 1411 E. 116th St. Carmel, IN 46032- rivoice� Proc Code Date Description Qty Charge Recei t Adjust Balance 746404 04/11/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Megan E Carr Balance Due: 47.00 ................ 746404 04/15/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Sarah Henderson Balance Due: 47.00 746404 04/07/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Melissa Liebner Balance Due: 47.00 ...............................---............ .__......... _ _ .. .__ _............_.._....- 746404 04/19/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Samuel A Philleo Balance Due: 47.00 ......................................................................................--......................... . 746404 04/01/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Shannon E Roberts Balance Due: 47.00 _..................._._..__._.._......_.........................._.._.. _..._......................................._..._................................. ........_.............. Invoice# 451454 Balance Due: — 3 PLEASE REMIT PAYMENT PROMPTLY ''moi