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
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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