HomeMy WebLinkAbout301915 08/18/16 CITY OF CARMEL, INDIANA VENDOR: 355031
ONE CIVIC SQUARE COMMUNITY OCCUPATIONAL HEALTH C$ldROK AMOUNT: $*******141.00*
CARMEL, INDIANA 46032 7169 SOLUTION CENTER CHECK NUMBER: 301915
CHICAGO IL 60677-7001 CHECK DATE: 08/18/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4340700 462057 141.00 MEDICAL FEES
Voucher No. Warrant No.
______
355031 Community Occupational Health Services Allowed 20____
7169 Solution Center
Chicago, IL 60877-7001
QNACCOUNT OFAPPROPRIATION FOR
108 ESE
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1081-99 462057 4340700 $ 141.00 | hereby certify that the attached invoica(s). or
biU(s) io (ara)true and correct and that the
materials orservices itemized thereon for
which charge iamade were ordered and
received except
August 10 2016
Signature
1 $ 141.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
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
8/2/16 462057 Pre-Employment Drug Testing $ 141.00
Total $ 141.00
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
Cc�rnrnunit `Occu atioYialwHea th Svs
"> �` 7('69Sol0�ion Center
y wCh cago SIL 601677 700"1��.
Phone ;3621=�034,1N,
FEIN: 35-1955223
A0 0 6 2016
Invoice --- I
11 2I V7
016 ��
Bill to: Lynn Russell For: Carmel Clay Parks &Recreation
Carmel Clay Parks &Recreation 07/16
1411 E. 116th St.
Carmel, IN 46032-
..... .
w #
462057,
Proc Code Date Description Qty Charge Receipt Adjust Balance
746404 07/1912016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Jessica A Bookout Balance Due: 47.00
746404 07/28/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Michael T Kaforke Balance Due: 47.00
746404 07/22/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Kennedy Visscher Balance Due: 47.00
Invoice# 462057 Balance Due: 1r.4?1EOOl�
Please remit payment promptly
8-8 ��