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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 A 115 C(I a On'IINOc!izITO &M!H,eappy,, `` 7�1�69Soluton Phone: 317-621=0341 FEIN: 35-1955223 DEC Z 0 2017 �Y. 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 1A-�D-�'7 Lino