The URL can be used to link to this page

Home My WebLink About319472 12/12/17 CITY OF CARMEL, INDIANA VENDOR: 355031 ONE CIVIC SQUARE COMMUNITY OCCUPATIONAL HEALTH QtIRQK AMOUNT: $********51.00* CARMEL, INDIANA 46032 7169 SOLUTION CENTER CHECK NUMBER: 319472 CHICAGO IL 60677-7001 CHECK DATE: 12/12/17 ITpN DEPARTMENT ACCOUNT _ PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1201 4358800 508196 51.00 TESTING FEES i VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) ALLOWED 20 ACCOUNTS PAYABLE VOUCHER Vendor# 355031 COMMUNITY OCCUPATIONAL HEALTH SERVI IN SUM OF$ CITY OF CARMEL 7169 SOLUTION CENTER An invoice orbill to be properly itemized must show:kind ofservice,where performed,dates service rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc. CHICAGO, IL 60677-7001 Payee $51.00 ON ACCOUNT OF APPROPRIATION FOR Purchase Order# Human Resources Terms Date Due PO,# ACCT# DATE INVOICE# DESCRIPTION DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT 508196 43-588.00 $51.00 1 hereby certify that the attached invoice(s),or 11/21/17 508196 $51.00 1201 101 1201 101 bill(s)is(are)true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except Tuesday, December 05,2017 Lamb, Barbara Director I 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 Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer Community Occupational Health Svs 7169 Solution'Center Chicago, IL 60677-7001 Phone: 317-621-0341 FEIN: 35-1955223 Invoice November 21, 2017 Bill to: Jim Spelbring For: Carmel Civilian Carmel Utilities 11/17 1 Civic Square Carmel,IN 46032- Invoice# 508196 Proc Code ICD Date Description tv Charge Receipt Adiust� Balance 80301 1) 11/05/2017 Rapid 5 Panel UDS 1.00 51.00 51.00 501.81 XA 2) W22.8XX A Joseph E Mercer XXX-XX-8658 Balance Due: 51.00 Invoice# 508196Balance Due: 51.00 Please remit payment promptly Sub 'f ed To NOV 3 0 2017 clerk Treasurer CITY OF CARMEL, INDIANA VENDOR: 355031 ONE CIVIC SQUARE COMMUNITY OCCUPATIONAL HEALTH QtIRQK AMOUNT: $********51.00* CARMEL, INDIANA 46032 7169 SOLUTION CENTER CHECK NUMBER: 319472 CHICAGO IL 60677-7001 CHECK DATE: 12/12/17 ITpN DEPARTMENT ACCOUNT _ PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1201 4358800 508196 51.00 TESTING FEES i VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) ALLOWED 20 ACCOUNTS PAYABLE VOUCHER Vendor# 355031 COMMUNITY OCCUPATIONAL HEALTH SERVI IN SUM OF$ CITY OF CARMEL 7169 SOLUTION CENTER An invoice orbill to be properly itemized must show:kind ofservice,where performed,dates service rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc. CHICAGO, IL 60677-7001 Payee $51.00 ON ACCOUNT OF APPROPRIATION FOR Purchase Order# Human Resources Terms Date Due PO,# ACCT# DATE INVOICE# DESCRIPTION DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT 508196 43-588.00 $51.00 1 hereby certify that the attached invoice(s),or 11/21/17 508196 $51.00 1201 101 1201 101 bill(s)is(are)true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except Tuesday, December 05,2017 Lamb, Barbara Director I 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 Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer Community Occupational Health Svs 7169 Solution'Center Chicago, IL 60677-7001 Phone: 317-621-0341 FEIN: 35-1955223 Invoice November 21, 2017 Bill to: Jim Spelbring For: Carmel Civilian Carmel Utilities 11/17 1 Civic Square Carmel,IN 46032- Invoice# 508196 Proc Code ICD Date Description tv Charge Receipt Adiust� Balance 80301 1) 11/05/2017 Rapid 5 Panel UDS 1.00 51.00 51.00 501.81 XA 2) W22.8XX A Joseph E Mercer XXX-XX-8658 Balance Due: 51.00 Invoice# 508196Balance Due: 51.00 Please remit payment promptly Sub 'f ed To NOV 3 0 2017 clerk Treasurer