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HomeMy WebLinkAbout318933 11/21/17 CITY OF CARMEL, INDIANA VENDOR: 355031 ONE CIVIC SQUARE COMMUNITY OCCUPATIONAL HEALTH QtIRQK AMOUNT: $##f■#*4235.00' ° CARMEL, INDIANA 46032 7169 SOLUTION CENTER CHECK NUMBER: 318933 CHICAGO IL 60677-7001 CHECK DATE: 11/21/17 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1081 4340700 506433 141.00 MEDICAL FEES 1081 4340700 507842 47.00 MEDICAL FEES 1081 4340700 507997 47.00 MEDICAL FEES Voucher No. Warrant No. 355031 Community Occupational Health Services Allowed 20 7169 Solution Center Chicago, IL 60677-7001 In Sum of$ $ 235.00 ON ACCOUNT OF APPROPRIATION FOR 108 ESE PO#or INVOICE NO. A6CCT#/TITLE AMOUNT Board Members Dept# 1081-99 507842 4340700 $ 47.00 1 hereby certify that the attached invoice(s), or 1081-99 506433 4340700 $ 141.00 bill(s)is(are)true and correct and that the 1081-99 507997 4340700 $ 47.00 materials or services itemized thereon for which charge is made were ordered and received except November 13, 2017 1PAN"VKVU Signature $ 235.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund Commun ®cupational.Health'Svs-3-1% 169ol�ution=Center Ch�,icagot IE-460677=7001 Phone 317=621 0341 7 v FEIN: 35-1955223 NOV Q 6 1011 BY: Invoice MMember''0 ;,�201y7 Bill to: Lynn Russell For: Carmel Clay Parks &Recreation Carmel Clay Parks &Recreation 8/17 1411 E. 116th St. Carmel, IN 46032- Inuo �e Proc Code Date Description 9-ty Charge Receipt AdMA Balance 746404 08/05/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Samantha J Hamilton Balance Due: 47.00 Invoice<# 50Z842.Balance We � 4 7- .'0 7. ' Please remit payment promptly I I-(�•1'1 L. - Gornr>nuni y Occupational Health Sus. 71,69 aolufion,.Center!, ,J,�- --�--- Cfica-o, Il�r 6Q677?7.001 —,.._.- Phone: 317-621-0341 FEIN: 35-1955223 NOV 0 6 2017 Invoice a©a�ember-0.2 20-1-7 Bill to: Lynn Russell For: Carmel Clay Parks &Recreation Carmel Clay Parks &Recreation 10/17 1411 E. 116th St. Carmel, IN 46032- Iriwoice Proc Code Date Description Qtv Change Recei t Adiust Balance 746404 10/26/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Elijah Bullard Balance Due: 47.00 ........................................_..._...................._...__................._....................._....._...._...... 746404 10/25/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Jessica Hintz Balance Due: 47.00 ----------- 746404 ---.746404 10/18/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Christopher Nguyen Balance Due: 47.00 .. ......... ... .......... ........ .... . .. ...... ........ .-.... .. .. _....__....... _..... Invoice# 506433$alance1A1=— 00 Please remit payment promptly ,� �rc--"----RI-xh- C.omtn-ui��ty4Qccu(za�lc►nal'-1�eatt:� :Sa�s�- - r71"69`�olLution Cen er hica o IL,��3677„�700 �ti. Phone: 317-621-0341 FEIN: 35-1955223 ° NOV 0 6 2017 BY: Invoice o ev tuber 02, 2Q17 Bill to: Lynn Russell For: Carmel Clay Parks &Recreation Carmel Clay Parks &Recreation 5/16 1411 E. 116th St. Carmel, IN 46032- Invoice#•: 507997 Proc Code Date Description Qtv Charge Receipt Adjust Balance 746404 05/25/2016 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Kelsey M Helstrom Balance Due: 47.00 Invoice# 507997 IBalance4Due r, � Please remit payment promptly