Loading...
HomeMy WebLinkAbout318736 11/21/2017 ��'`,*� CITY OF CARMEL, INDIANA VENDOR: 355031 (y ONE CIVIC SQUARE COMMUNITY OCCUPATIONAL HEALTH ROK AMOUNT: $********83.00* ?Q CARMEL, INDIANA 46032 7169 SOLUTION IsON CENTER CHECK NUMBER: 318736 roN�: CHECK DATE: 11/21/17 ` DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1120 4340799 507636 83.00 OTHER MEDICAL FEES nQ n 2 n $ « \ - # k 2 O\ 2k k ƒ CA D b : \ O r 2 ® m 0 e % a 2 E a ) z q k o 2 O (D 0 $ q / E m m o § # -n # w 2 5 ] D q \ m 0a CD T k t 2 > - O D / k E CD I m f § © > & I ® 0z / $ 0 > & _ 9 3 7 / 7 E m | \ 8 . $ & ■ - 2 > 3 L7 k / § @ ) § 7A g ( / 2 J m c (D o CL CD #_ - E 3 M / 3 £ z E § : _ CL o C . E 0 i ' 3 $ 3 § \ \ / / 0 \ k O E » £ $ « E / E \ CL % / R \ 4 E ( U c |o cr y 7 K« �z m ] E / \ CL J \ § m \ CD G CD CL \ D \ 0 \ 0 £ § k a -n < @2 0 co _ o aCD (3 \ � ) \ k a 2 \ - a � \ 3 Z ; [ - § CL § k / B/ 00. \ 2 eE a 0 > }ƒ (D \ �\ ) o @4 > ° 3 \ $ i CD CD § 0 n 2 / j E \ \ r- 0 / Z « § A E ) C O 0 % ( / E $ } = , - 0 } g 2 / E M -n / § \ f \ ] f k « 7 m z E \ E > J g \ in Q . 00 z ° \ Community Occupational Health Svs 7169 Solution Center Chicago, IL 60677-7001 Phone: 317-621-0341 FEIN: 35-1955223 Invoice November 02, 2017 Bill to: Accounts Payable For: Carmel Fire Department City of Carmel 6/17 1 Civic Square Carmel, IN 46032- Invoice# 507636 Proc Code Date Description QtV Charge Receipt Adjust Balance 80301 06/02/2017 Rapid 5 Panel UDS 1.00 51.00 51.00 82075 06/02/2017 Breath Alcohol Test 1.00 32.00 32.00 Jason D Wendzel XXX-XX-1164 Balance Due: 83.00 Invoice# 507636 Balance Due: 83.00 Please remit payment promptly