HomeMy WebLinkAbout303815 10/06/16 ��.�,qr, CITY OF CARMEL, INDIANA VENDOR: 355031
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it ONE CIVIC SQUARE COMMUNITY OCCUPATIONAL HEALTH%tIRQK AMOUNT: $*******282.00*
s, ?Q CARMEL, INDIANA 46032 7169 SOLUTION CENTER CHECK NUMBER: 303815
'$,,ETON�.` CHICAGO IL 60677.7001 CHECK DATE: 10/06/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4340700 466701 282.00 MEDICAL FEES
Voucher No. Warrant No.
______
855031 Community Occupational Health Services /Ukowaai 20____
71G8Solution Center
Chicago, IL 60677-7001
ONACCOUNT OFAPPROPRIATION FOR
108 ESE
PO#or INVOICE NO. ACCT#1TITLE AMOUNT Board Members
Dept#
luul-oy 466701 4340700 $ 282.00 | hereby certify that the aftochedinvnim(s). or
biU(s)io (are)true and correct and that the
materials orservices itemized thereon for
which charge iomade were ordered and
received except
September
Signature
Accounts Payable Crdi oto
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
9/16/16 466701 Pre-Employment Drug Testing $ 282.00
Total Is 282.00
I 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
120
Clerk-Treasurer
Co untfy0ecupYa iona�<Fi, Ith�Sys
7169 Solutiorn� Cente�Y�`�"�
CI%e{ago'�:IL�60677 7001 DECEIVED
Phones-.�3�1.7:621-.034.•1;��,,�
FEIN: 35-1955223 SEP 22 2016
BY:
Invoice
iOdt-m be
Bill to: Lynn Russell For: Carmel Clay Parks &Recreation
Carmel Clay Parks &Recreation 09/16
1411 E. 116th St.
Cannel, IN 46032-
In�oige#st 4`,6.101 j f
Proc Code Date Description Qty Charge ReceiptAdjust Balance
746404 09/01/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Emily C Carr Balance Due: 47.00
746404 09/08/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Mikayla M Hazelwood Balance Due: 47.00
746404 _ 09/07/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Alexis Higgins Balance Due: 47.00
746404 09/15/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Dymond F Johnston Balance Due: 47.00
746404 09/07/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Mariah N Schaefer Balance Due: 47.00
746404 09/15/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Kayla Williams Balance Due: 47.00
Invoice# 466701 Balance Due: 28200
Please remit payment promptly