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Home My WebLink About312783 6/16/2017 CITY OF CARMEL, INDIANA VENDOR: 355031 ONE CIVIC SQUARE COMMUNITY OCCUPATIONAL HEALTHNROK AMOUNT: $**""*1,504.00" r° CARMEL, INDIANA 46032 CHICAGO I�L'606CENTER 77-001 CHECK NUMBER: 312783 CHECK DATE: 06/16/17 � ON� DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1081 4340700 490375 517.00 MEDICAL FEES 1125 4340700 490375 47.00 MEDICAL FEES 1081 4340700 490864 329.00 MEDICAL FEES 1081 4340700 492287 517.00 MEDICAL FEES 1125 4340700 492287 94.00 MEDICAL FEES $ / k_ 2 k_ 2 0 k / o G % G % _ 0 k � CD c o o > / o n 0 E 00 � o 3 CD w 0 . I f t t t t t \ E / 2 E PO N) o 0 o a o 2 £ @ ] ; k % $ % q m ■ a o o c ( \ w w # m a j O \ < 2. & 7 e -� m w SSS w \ k 0 E o w � � CD / / / / / m q o CD / / J x 0 0 0 0 ® CO) o $ 2 2 [ / w w V) -W <0 <0 \ P 2 0 E 2 - cn 2 \ 2 p v \ / 0 / 2 R k k S R \ / § k ] ¥ ° ° \ = @ E 7 § f § $ < = a & ± M E a CD q 0 G > g q (n7 - n - / � a ) M \ @ ¥ ¥ \ k » \ ƒ k § \ _ % 2 0 \ ° M S _ C? o a a = E w 0 7 & & . < 0CL § » < 2 \ / } / 7 5 / | 0 / Community Occupational Health Svs 7169 Solution Center Chicago, IL 60677-7001 Phone: 317-621-0341 �� FEIN: 35-1955223 7 OiA1�! 2013 BY: Invoice May 17, 2017 Bill to: Lynn Russell For: Carmel Clay Parks & Recreation Carmel Clay Parks & Recreation 05/17 1411 E. 116th St. Carmel, IN 46032- Invoice# 490864 Proc Code Date Description QtV Charge Receipt Adjust Balance 746404 05/15/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Stephanie J Burt Balance Due: 47.00 746404 05/04/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Graham Cecil Balance Due: 47.00 746404 05/11/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Abbi Criswell Balance Due: 47.00 746404 05/05/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Kate Ewing Balance Due: 47.00 746404 05/05/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Graham C Hatfield Balance Due: 47.00 746404 05/11/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Kathy Heier Balance Due: 47.00 746404 05/10/2017 Drug Screen -Non NIDA 5 Panel 1.00 47.00 47.00 Casey Horn Balance Due: 47.00 Invoice# 490864 Balance Due: 329.00 Please remit payment promptly �_aa_t1 L-vJY'n .. Cut and return with payment Invoice # 492287 (continued)page 2 Augustina SAlusso Balance Due: 47.00 746404 05/23/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Ashley M Steel Balance Due: 47.00 Invoice# 492287 Balance Due: 611.00 Please remit payment promptly Cut and return with payment Community Occupational Health Svs ��V-) ' '� 7169 Solution Center Chicago, IL 60677-7001 Phone: 317-621-0341 r FEIN: 35-1955223 Rte' t~ V ., s I•�'`r -x 2011 s BYE Invoice May 17, 2017 Bill to: Lynn Russell For: Carmel Clay Parks & Recreation Cannel Clay Parks & Recreation 05/17 1411 E. 116th St. Carmel, IN 46032- Invoice# 490375 Proc Code Date Description QtV Charge Receipt Adjust Balance 746404 05/04/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Megana V Bammidi Balance Due: 47.00 746404 05/12/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Emily Gordon Balance Due: 47.00 746404 05/04/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Andrew O Gostomelsky Balance Due: 47.00 746404 05/12/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Emily J Hassett Balance Due: 47.00 746404 05/03/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Kassandra K Huey Balance Due: 47.00 746404 05/11/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Gabriel Lee Balance Due: 47.00 746404 05/04/2017 Drug Screen-Non NIDA 5 Pane! 1.00 47.00 47.00 Haley E Lipps Balance Due: 47.00 746404 05/05/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Richard J Ransford Balance Due: 47.00 7.36404 05/01/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Natalie F Rumreich Balance Due: 47.00 746404 05/13/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Evan Shears Balance Due: 47.00 746404 05/13/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Casey E Storms Balance Due: 47.00 746404 05/05/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Community Occupational Health Svs 7169 Solution Center Chicago, IL 60677-7001 Phone: 317-621-0341 4 ^C �e FEIN: 35-1955223 RECEIVED JUN 062011 BY:.............................. Invoice June 02, 2017 Bill to: Lynn Russell For: Carmel Clay Parks & Recreation Carmel Clay Parks & Recreation 05/17 1411 E. 1 16th St. Cannel, M 46032- Invoice# 492287 Proc Code Date Description Qty Charge Receipt Adjust Balance 746404 05/19/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Arinn Cox Balance Due: 47.00 746404 05/20/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Rachel E Gallagher Balance Due: 47.00 746404 05/21/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Elisebeth C Huettemann Balance Due: 47.00 746404 05/24/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Julianna Kessilyas Balance Due: 47.00 746404 05/18/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Nicole J Knott Balance Due: 47.00 746404 05/31/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Jon O'Brien Balance Due: 47.00 746404 05/19/2017 Drug Screen -Non NIDA 5 Panel 1.00 47.00 47.00 Victoria B Oldson Balance Due: 47.00 746404 05/19/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Samuel A Philleo Balance Due: 47.00 746404 05/22/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Shivasaran Rajendran Balance Due: 47.00 746404 05/26/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Anja M Reese Balance Due: 47.00 746404 05/19/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Majd Sadek Balance Due: 47.00 746404 05/25/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 (A,-7 '17 CN 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 5/17/17 490375 Pre-Employment Drug Testing 41666 $ 517.00 5/17/17 490375 Pre-Employment Drug Testing 41666 $ 47.00 5/17/17 490864 Pre-Employment Drug Testing 41666 $ 329.00 6/2/17 492287 Pre-Employment Drug Testing 41737 $ 94.00 6/2/17 492287 Pre-Employment Drug Testing 41737 $ 517.00 Total $ 1,504.00 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