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HomeMy WebLinkAbout309889 04/04/17 Q CITY OF CARMEL, INDIANA VENDOR: 355031ONE CIVIC SQUARE COMMUNITY OCCUPATIONAL HEALTH�tlROK AMOUNT: S****"***94.00* CARMEL, INDIANA 46032 7169 SOLUTION CENTER CHECK NUMBER: 309889 CHICAGO IL 60677-7001 CHECK DATE: 04/04/17 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1081 4340700 481849 94.00 MEDICAL FEES C) = -0 CA) \ 0 k 00 CD 0 � / > 2 & © r f \ # < 0 = ko 2 o E § o ] 3 2 m _ --1 / 0 C ( = ® § o e� � / 0 S 0 CO)CL / k 0 # 1 —4 CD / � ( q 2 q 2 -4 ƒ7 J / R a 2 2 \ w \_ I P CL 2 O § o Z co / \ 3 e 2 S / § G ] E / E > n M CD ¢ CD CD 3 ƒ $ CD E & M E • B E q ° 0 Q & 0 CD q Co k / ® 0CD \ ( & m q / / \ m -. C / 13 0 k = \ k \ / § / \ / k / / R §» & j h CL CD CD �\ / m m -(W | o \ Community Occupational Health Svs 7169 Solution Center Chicago, IL 60677-7001 RsrVED Phone: 317-621-0341 FEIN: 35-1955223 MAR 2 4 2017 BY: . Invoice February 15, 2017 Bill to: Lynn Russell For: Carmel Clay Parks & Recreation Carmel Clay Parks & Recreation 02/17 1411 E. 116th St. Carmel, IN 46032- Invoice# 481849 Proc Code Date Description Qty_ Charge Receipt Adjust Balance 746404 02/02/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Gabriela E Brito Balance Due: 47.00 746404 02/01/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Stacey Diem Balance Due: 47.00 Invoice# 481849 Balance Due: 94.00 Please remit payment promptly 3-3oc� Cul and return with payment