The URL can be used to link to this page

Home My WebLink About303205 09/22/16 %'��q3f( - CITY OF CARMEL, INDIANA VENDOR: 355031 ® 1 ONE CIVIC SQUARE COMMUNITY OCCUPATIONAL HEALTH Q19OK AMOUNT: $*******705.00* ;. a� CARMEL, INDIANA 46032 7169 SOLUTION CENTER CHECK NUMBER: 303205 9�'�F6ri.�°` CHICAGO IL 60677-7001 CHECK DATE: 09/22/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1081 4340700 464647 658.00 MEDICAL FEES 1091 4340700 464647 47.00 MEDICAL FEES Voucher No. Warrant No. 355031 Community Occupational Health Services Allowed 20 7169 Solution Center Chicago, IL 60677-7001 In Sum of$ $ 705.00 ON ACCOUNT OF APPROPRIATION FOR 108 ESE /109 Monon Center PO#or INVOICE NO. ACCT#/TITL AMOUNT Board Members Dept# 1081-99 464647 4340700 $ 658.00 1 hereby certify that the attached invoice(s), or 1091 464647 4340700 $ 47.00 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 September 14, 2016 Signature $ 705.00 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 9/2/16 464647 Pre-Employment Drug Testing $ 658.00 9/2/16 464647 Pre-Employment Drug Testing $ 47.00 Total $ 705.00 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 omrn,unrty Occu ational N alth SS lam•" �F�7169r�S,oluttonCer�te,� y' • , p l� �p= lcago, ILE60677:,700}15 : Phone: 317 621 `0341 FEIN: 35-1955223 Q Q X016 Invoice Septernber02 2016 ;, Bill to: Lynn Russell For: Carmel Clay Parks &Recreation Carmel Clay Parks &Recreation 08/16 1411 E. 116th St. Carmel, IN 46032- Invoice# 464647 Proc Code ICD Date Description QtV Char-e Receipt Adjust Balance 746404 08/17/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Haley C Beach Balance Due: 47.00 746404 08/25/2016 Dru g Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Anthony L Bennett Balance Due: 47.00 746404 08/11/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Hannah B Dunco Balance Due: 47.00 746404 08/12/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Jessica E Eimerman Balance Due: 47.00 746404 08/11/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Garrett A Ford Balance Due: 47.00 746404 08/31/2016 Dru Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Taryn M Ford Balance Due: 47.00 746404 08/23/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Claire Hatton Balance Due: 47.00 __.. ..._ .._ .._ -.... ....... ...__ ......... ................ _....... 746404 1) 08/09/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 S00.80XA 2) M25.522 Amy L Kranz Balance Due: 47.00 746404 1 08/05/2016 D*r'ug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 S63.92XA 2) W 18.39XA Erin C Libby Balance Due: 47.00 746404 08/18/2016 D rug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Amanda D Maddox Balance Due: 47.00 �- c CEJ �'�4`64fi4p7'(cohTin ed)page 2 746404 1) 08/09/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 S80.11XA 2)Y93.F9 Mallory C Marrs Balance Due: 47.00 746404 08/31/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Tayler B Mobley Balance Due: 47.00 746404 08/12/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Margaret P Smith Balance Due: 47.00 746404 08/26/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Michael Smith Balance Due: 47.00 746404 08/25/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Adam J Williams Balance Due: 47,00 Invoice# 464647 Balance Due: 7Q5Ilb" Please remit payment promptly