HomeMy WebLinkAbout315393 08/29/17 ,�-"`���''� CITY OF CARMEL, INDIANA VENDOR: 355031
0 ONE CIVIC SQUARE COMMUNITY OCCUPATIONAL HEALTH CMRVK AMOUNT: $ 51.00
=a CARMEL, INDIANA 46032 7169 SOLUTION CENTER CHECK NUMBER: 315393
+• CHICAGO IL 60677-7001 CHECK DATE: 08/29/17
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 498687 51.00 OTHER EXPENSES
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Community Occupational Health Svs
7169 Solution Center
Chicago, IL 60677-7001
Phone: 317-621-0341
FEIN: 35-1955223
Invoice
August 02, 2017
Bill to: Jim Spelbring For: Carmel Civilian
Carmel Utilities 07/17
1 Civic Square
Carmel, IN 46032
Invoice# 498687
Proc Code ICD Date Description Qty Charge Receipt Adjust Balance
80301 1) 07/31/2017 Rapid 5 Panel UDS 1.00 51.00 51.00
S39.012A
2)
Y33.XXX
A
Michael B Turner XXX-XX-1578 Balance Due: 51.00
Invoice# 498687 Balance Due: 51.00
Please remit payment promptly
iCut and return with payment
Please remit 51.00 to Community Occupational Health Services
7169 Solution Center
Please place invoice number 498687 on check Chicago,IL 60677-7001
Phone: 317-621-0341