HomeMy WebLinkAbout309471 03/27/17 CITY OF CARMEL, INDIANA VENDOR: 355031
AMOUNT: S******■#83.00*
ONE CIVIC SQUARE COMMUNITY OCCUPATIONAL HEALTH CHECK
CARMEL, INDIANA 46032 7169 SOLUTION CENTER CHECK NUMBER: 309471
CHICAGO IL 60677-7001 CHECK DATE: 03/27/17
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4340799 484013 83.00 OTHER MEDICAL FEES
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Community Occupational Health Svs
7169 Solution Center
Chicago, IL 60677-7001
Phone: 317-621-0341
FEIN: 35-1955223
Invoice
March 02, 2017
Bill to: Accounts Payable For: Carmel Fire Department
City of Carmel 2/17
1 Civic Square
Carmel, IN 46032-
Invoice # 484013
Proc Code Date Description Qty Charge Receipt Adjust Balance
80301 02/23/2017 Rapid 5 Panel UDS 1.00 51.00 51.00
82075 02/23/2017 Breath Alcohol Test 1.00 32.00 32.00
Adam D Holden XXX-XX-4772 Balance Due: 83.00
Invoice# 484013 Balance Due: 83.00
Please remit payment promptly
Cut and return with payment
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