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HomeMy WebLinkAbout316554 9/26/2017 1 ur C�9gr �;� E CITY OF CARMEL, INDIANA VENDOR: 355031 COMM e ONE CIVIC SQUARE COMMUNITY OCCUPATIONAL HEALTH�RVK AMOUNT: $.......329.00* +19 ?� CARMEL, INDIANA 46032 7169 SOLUTION CENTER CHECK NUMBER: 316554 •M�roN�. CHICAGO IL 60677-7001 CHECK DATE: 09/26/17 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1081 4340700 500044 282.00 MEDICAL FEES 1091 4340700 500044 47.00 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 9/5/17 500044 Pre-Employment Drug Testing 50365 $ 282.00 9/5/17 500044 Pre-Employment Drug Testing 50365 $ 47.00 Total $ 329.00 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 Phone: 317-621-0341 FEIN: 35-1955223 RECr,—A MD SEP 0 8 2011 BY.............................. Invoice September 05, 2017 Bill to: Lynn Russell For: Carmel Clay Parks & Recreation Carmel Clay Parks & Recreation 08/17 1411 E. 116th St. Carmel, IN 46032- Invoice # 500044 Proc Code Date Description Qty Charge Receipt Adjust Balance 746404 08/31/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Breana S Allen Balance Due: 47.00 746404 08/11/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Erica Foreman Balance Due: 47.00 746404 08/19/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Anna Good Balance Due: 47.00 746404 08/31/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Myisha Holmes Balance Due: 47.00 746404 08/17/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Rebecca L Kent Balance Due: 47.00 746404 08/25/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Charlsie Krauss Balance Due: 47.00 746404 08/17/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 William Schwab Balance Due: 47.00 Invoice# 500044 Balance Due: 329.00 Please remit payment promptly ci- Cut and return with payment