HomeMy WebLinkAbout320573 01/11/18 CITY OF CARMEL, INDIANA VENDOR: 355031
y ONE CIVIC SQUARE COMMUNITY OCCUPATIONAL HEALTH 6kIROK AMOUNT: $*******235.00*
f ?q CARMEL, INDIANA 46032 7169 SOLUTION CENTER CHECK NUMBER: 320573
9y«oN CHICAGO IL 60677-7001 CHECK DATE: 01/11/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4340700 511402 235.00 MEDICAL FEES
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
VOUCHER NO. WARRANT NO.
An invoice of bill to be properly itemized must show;kind of service,where performed,dates service rendered,by
Vendor# 355031 Allowed 20 whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
Community Occupational Health Services Payee
7169 Solution Center
Chicago,IL 60677-7001 In Sum of$ 355031 Purchase Order#
Community Occupational Health Services Terms
$ 235.00 7169 Solution Center Date Due
Chicago, IL 60677-7001
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO#or INVOICE NO. ACCT#f TITLE AMOUNT Invoice Invoice Description
Dept# Date Number (or note attached invoice(s)or bill(s)) PO# Amount
1081-99 511402 4340700 $ 235.00 Board Members 12/15/17 511402 Pre-Employment Drug Testing xx6301 $ 235.00
I 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
$ 235.00 Total $ 235.00
January 4,2018
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
Cost distribution ledger classification if
claim paid motor vehicle highway fund Signature 20_
Accounts Payable Coordinator Clerk-Treasurer
Title
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Phone: 317-621=0341
FEIN: 35-1955223
DEC Z 0 2017
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Invoice
Dfecember,.415,,20'17
Bill to: Lynn Russell For: Carmel Clay Parks &Recreation
Carmel Clay Parks &Recreation 12/17
1411 E. 116th St.
Carmel, IN 46032-
.._...•____._.._......_._.___.._...........__.____..__..__._...__..___.._.___—___v_.___._..__......_..___...__..._..._..... ..._
Proc Code Date Description QtV Charae Receipt Adjust Balance
746404 12/07/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Faith L Agnew Balance Due: 47.00
746404 12/07/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Tele Barnett Balance Due: 47.00
746404 12/07/2017 Drug Screen-Non NIDA 5 Panel 1.00 47..00_ 47.00
-- . _ Xavon Breland Balance Due:-- -- - -47.00
746404 12/08/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Lauren Ross Balance Due: 47.00
746404 12/09/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Rebekah K Shirar Balance Due: 47.00
Invoice# 511402 an� 2x35,00
Please remit payment promptly
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