HomeMy WebLinkAbout304266 10/20/16 „A
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CITY OF CARMEL, INDIANA VENDOR: 355031
ONE CIVIC SQUARE COMMUNITY OCCUPATIONAL HEALTH%k!RQK AMOUNT: $•..."""470.00'
:•. ;� CARMEL, INDIANA 46032 7169 SOLUTION CENTER CHECK NUMBER: 304266
CHICAGO IL 60677-7001 CHECK DATE: 10/20/16
A SON GO
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4340700 468119 423.00 MEDICAL FEES
1125 4340700 468119 47.00 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
10/4/16 468119 Pre-Employment Drug Testing $ 423.00
10/4/16 468119 Pre-Employment Drug Testing $ 47.00
Total $ 470.00
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
71.69 Solution Center
Chicago, IL 60677-7001
In Sum of$
$ 470.00
ON ACCOUNT OF APPROPRIATION FOR
101 General/108 ESE
PO#or INVOICE NO. A.CCT#/TITL AMOUNT Board Members
Dept#
1081-99 468119 4340700 $ 423.00 1 hereby certify that the attached invoice(s), or
1125 468119 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
October 12, 2016
Signature
$ 470.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
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hicago, I '..60677;70
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7 2016
Invoice
October-04,2010=7
Bill to: Lynn Russell For: Cannel Clay Parks & Recreation
Carmel Clay Parks & Recreation 09/16
1411 E. 116th St.
Cannel, IN 46032-
Icosce;.# 46811=9-
Proc Code Date Description aty Charge Receipt Adjust Balance
746404 09/16/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Brittany L Bowers Balance Due: 47.00
746404 09/29/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Hallie N Brake Balance Due: 47.00
746404 09/26/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Arianna Cruz Balance Due: 47.00
746404 09/23/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 41.00
Clarissa Degan Balance Due: 47.00
746404 09/29/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Daniel Keim Balance Due: 47.00
746404 09/22/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Sonal F Kumar Balance Due: 47.00
746404 09/30/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Conner Lach Balance Due: 47.00
746404 09/24/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Ethan Montoya Balance Due: 47.00
746404 09/17/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00- 47.00
Brennan M Turi Balance Due: 47.00
746404 09/23/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Bruce Wright Balance Due: 47.00
1e co Invoice# 468119 Balance Due: 470.00
Please remit payment promptly