HomeMy WebLinkAbout315253 8/29/2017 4� `',yR
,, . CITY OF CARMEL, INDIANA VENDOR: COMM AMOUNT: S`""""'611.00•
ONE CIVIC SQUARE COMMUNITY OCCUPATIONAL HEALTH CHECK
"'- 7169 SOLUTION CENTER CHECK NUMBER: 315253
=q; CARMEL, INDIANA 46032 CHICAGO IL 60677-7001 CHECK DATE: 08/29/17
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4340700 497751 282.00 MEDICAL FEES
1125 4340700 497751 47.00 MEDICAL FEES
1081 4340700 499142 282.00 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
8/2/17 497751 Pre-Employment Drug Testing 50275 $ 282.00
8/2/17 497751 Pre-Employment Drug Testing 50275 $ 47.00
8/16/17 499142 Pre-Employment Drug Testing 50274 $ 282.00
Total $ 611.00
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
Community Occupational Health Svs
' 7169 Solution Center
Chicago, IL 60677-7001 R vE D
Phone: 317-621-0341
FEIN: 35-1955223 AUG Q 7 1011
BY:
Invoice
August 02, 2017
Bill to: Lynn Russell For: Carmel Clay Parks &Recreation
Carmel Clay Parks &Recreation 07/17
1411 E. 116th St.
Carmel, IN 46032- _
Invoice# 497751
Proc Code Date Description Qty Charge Recei t Adjust Balance
746404 07/27/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Nathan Chandler Balance Due: 47.00
746404 07/12/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Crystal L George Balance Due: 47.00
.......___._..._____
746404 05/12/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Cody M McCollum Balance Due: 47.00
746404 07/18/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Stephfonique Seymour Balance Due: 47.00
746404 07/29/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Kaman C States Balance Due: 47.00
746404 07/12/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
shyniqua Thompson Balance Due: 47.00
746404 07/12/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
emily utz Balance Due: 47.00
Invoice# 497751 Balance Due: 329.00
Please remit payment promptly
�.7
Cut and return with payment
Community Occupational Health Svs
7169 Solution Center
Chicago, IL 60677-7001
Phone: 317-621-0341
FEIN: 35-1955223
AUG 2 1 2017
i
BY:..
Invoice
August 16, 2017
Bill to: Lynn Russell For: Carmel Clay Parks & Recreation
Carmel Clay Parks & Recreation 08/17
1411 E. 116th St.
Carmel, IN 46032-
��� Invoice# 499142
Proc Code ICD Date Description QtV Charge Receipt Adjust Balance
746404 08/08/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
anna Konig Balance Due: 47.00
746404 1) 06/12/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
S93.402A
2)
W10.1XX
A
Melissa Liebner Balance Due: 47.00
746404 08/09/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Jessica Moore Balance Due: 47.00
746404 08/08/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Natalie Over Balance Due: 47.00
746404 08/03/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Megan C Smith Balance Due: 47.00
746404 08/03/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Logan K Stearns Balance Due: 47.00
Invoice# 499142 Balance Due: 282.00
Please remit payment promptly
Cut and return with payment
Or