HomeMy WebLinkAbout319702 12/15/17 0''€� CITY OF CARMEL, INDIANA VENDOR: 355031
ONE CIVIC SQUARE COMMUNITY OCCUPATIONAL HEALTH I9%jR9K AMOUNT: $*******423.00*
CARMEL, INDIANA 46032 7169 SOLUTION CENTER CHECK NUMBER: 319702
q�(TON. ,g CHICAGO IL 60677-7001 CHECK DATE: 12/15/17
DEPARTMENT ACCOUNT PO NUMBER
INVOICE NUMBER AMOUNT DESCRIPTION
1081 4340700 508430 282.00 MEDICAL FEES
1081 4340700 510108 141.00 MEDICAL FEES
Voucher No.--. Warrant No.
355031 Community Occupational Health Services Allowed
7169 Solution Center 20
Chicago, IL 60677-7001
In Sum of$
$ 282.00
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO#or
Dept# INVOICE NO. CCT#/TITL AMOUNT Board Members
1081-99 508430 4340700 $ 282.00 1 hereby certify that the attached invoice(s), or
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
December 8, 2017
Signature
$ 282.00 Accounts Payable Coordinator
Cost distribution ledger classification if
Title
claim paid motor vehicle highway fund
Community Occupational Health Svs
7169 Solution Center
Chicago, IL 60677-7001
Phone: 317-621-0341
FEIN: 35-1955223
Invoice
overnb�er
Bill to: Lynn Russell For: Carmel Clay Parks &Recreation
Carmel Clay Parks &Recreation 11/17
1411 E. 116th St.
Carmel, IN 46032-
Invoice# 508430
Proc Code Date Description Qty Charge Recei t Adiust Balance
746404 11/08/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Bill Alexander Balance Due: 47.00
746404 11/16/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Alora Cooper Balance Due: 47.00
746404 11/16/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Grace Peric Balance Due: 47.00
_...._._......_. . . ........ ....... ... . ..................... ..... .... ..... ................ .. .......
746404 11/08/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Thalia Sanchez-Cain Balance Due: 47.00
-....._.. ... ----....._........_..._....._._..._.._........................................................
.
746404 11/20/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Alexandra N Wertz Balance Due: 47.00
..............._.............................................._..............................................................................................
746404 11/20/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Latalya M White Balance Due: 47.00
` <Invoice# 508430 Balance-Due: _5,82:00
Please remit payment promptly
Voucher No. Warrant No.
355031 Community Occupational Health Services Allowed 20
7169 Solution Center
Chicago, IL 60677-7001
In Sum of$
$ 141.00
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1081-99 510108 4340700 $ 141.00 1 hereby certify that the attached invoice(s), or
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
December 12, 2017
Signature
$ 141.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
Comunit"-0cc_r�Pataonal Health Svs
7169 Solution�Cente�
Chicago, IL60677F7001_
Fy �•,
Phone.;s3'1,7�621.034.1g
FEIN: 35-1955223
Invoice
�D'ecernber�0�4y��-017"�
Bill to: Lynn Russell For: Carmel Clay Parks &Recreation
Carmel Clay Parks &Recreation 11/17
1411 E. 116th St.
Carmel,IN 46032-
Inuo�ce
Proc Code Date Description Qty Change Recei t Adjust Balance
746404 11/28/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Xyrese Breland Balance Due: 47.00
_.__._..-_................._..__...._._......_...:... .....:........_...._._..._..............._.........................._......_..................................
746404 11/20/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Athena A Calderon Balance Due: 47.00
.......................................................
746404 11/29/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00' = 47.00
Bella Harrison Balance Due: 47.00
Invoice# 510108 Balance Due: w 7 n��
Please remit payment promptly