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Home My WebLink About260411 07/07/16 J�%�4�'t� CITY OF CARMEL, INDIANA VENDOR: 355031 ® ONE CIVIC SQUARE COMMUNITY OCCUPATIONAL HEALTHQ�RVK AMOUNT: S;"""'564.00` s �� CARMEL, INDIANA 46032 7166 SOLUTION CENTER CHECK NUMBER- 260411 °� �? CHECK DATE: 07/07/16 ,y��oN�, CHICAGO IL 60677-7001 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1081 4340700 453075 282.00 MEDICAL FEES 1081 4340700 454318 47.00 MEDICAL FEES 1081 4340700 457655 188.00 MEDICAL FEES 1125 4340700 457655 47.00 MEDICAL FEES Voucher No. Warrant No. 355031 Community Occupational Health Servilces Allowed 20 7169 Solution Center Chicago, IL 60677-7001 In Sum of$ $ 564.00 ON ACCOUNT OF APPROPRIATION FOR 101 General/108 ESE PO#or Dept# INVOICE NO. CCT#/TITL Board Members AMOUNT I 1081-99 453075 4340700 $ 282.00 1 hereby certify that the attached invoice(s), or 1081-99 454318 4340700 $ 47.00 bill(s) is(are)true and correct and that the 1125 457655 4340700 $ 47.0;0 materials or services itemized thereon for 1081-99 457655 4340700 $ 188.00 which charge is made were ordered and received except June 29, 2016 i Signature $ 564100 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund i Corn nit"y,ap Oc apdo al_He lthrSvs { 4 7T69 Solutign Centerl Chicago 1L 160677;7001, Phone. 317-621-0341 CEIVRE FEIN: 35-1955223 JUN 28 2 116 7BY: _-=I :Invoice May 03F'201_fi Bill to: Lynn Russell For: Carmel Clay Parks &Recreation Carmel Clay Parks &Recreation 04/16 1411 E. 116th St. Carmel, IN 46032- Iivoice�#.;�i453:0'7 Proc Code Date Description QtV Charge Receipt Adiust Balance 746404 04/28/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Abby Fogleman Balance Due: 47.00 746404 04/21/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Sierra S Holmes Balance Due: 47.00 746404 04/21/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Meghan F Lacy Balance Due: 47.00 746404 04/20/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Grace C Moyer Balance Due: 47.00 ............ .............................................. ........ ................................ ............. 746404 04/21/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Tulsi V Patel Balance Due: 47.00 746404 04/20/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Casey E Storms Balance Due: 47.00 Invoice# 453075 Balance Due: PLEASE NOTE: Effective 6/1/16 there will be a fee increase for a select set of services CommunityaOit, tionahHealth -vs 7 1.69 Solution Center. Chicago, ILu60677=-7001. - Pfione: 3'17=621=034'1 CE' I FEIN: 35-1955223 JUN 2.8 2016 BY: Invoice Bill to: Lynn Russell For: Carmel Clay Parks &Recreation Carmel Clay Parks &Recreation 05/16 1411 E. 116th St. Cannel, IN 46032- Invorce Proc Code Date Description Qty Charge Receipt Adjust Balance 746404 05/01/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Zachary T Kogler Balance Due: 47.00 Invoice# 454318 Balance Due: PLEASE NOTE: Effective 6/1/16 there v ill be a fee increase for a select set of services Com,mumty'Occupatio�al Healhs '` 71��9}Solution�sCenter�.� Chicago, IL�606T- T-70011 .,:. 'Phone:°�3:1'>7.�-621''_0.341 FEIN: 35-1955223 JUN 27 2016 BY: Invoice I Ju=ne 1"5;;20'16 Bill to: Lynn Russell For: Carmel Clay Parks &Recreation Carmel Clay Parks &Recreation 6/16 1411 E. 116th St. Carmel, IN 46032- Invoice#�457.655�,v-�-Y Proc Code ICD Date Description 2Y Charge Receipt Adjust Balance 746404 06/06/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Emily B Abshire Balance Due: 47.00 �_........ -----------.._..__._...._.... ..............__.........._.......................... 746404 1 05/23/2016 Drug ...................__.._.._............_.......... Screen-Non NIDA 5 Panel 1.00 47.00 47.00 S90.31 XA 2) W 16.532A Ellen B Blackburn Balance Due: 47.00 ...._....._ --- .........._.....__........_-_..._ -- ---- -- ---..........-.-..---- . ...... 746404 06/06/2016 DrugScreen-Non NIDA 5 Panel 1.00 47.00 47.00 Janet C Karsas Balance Due: 47.00 ... . ._._._._......._...... ..... . ._. ... . . 746404 06/01/2016 DrugScreen-Non NIDA 5 Panel 1.00 47.00 47.00 Nigel Raimondo Balance Due: 47.00 ..................................................................._. ....__........................ .............. 746404 1 06/06/2016 DrugScreen-Non NIDA 5 Panel 1.00 47.00 47.00 S80.21 1A 2) Y04.1 XXA / 041 , / Aimee E Rich Balance Due: 47.00 Invoice# 457655 Balance Due: 235f00 PLEASE NOTE: Effective 6/1/16 there ill be a fee increase for a select set of services