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HomeMy WebLinkAbout320878 01/17/18 C4 4. CITY OF CARMEL, INDIANA VENDOR: 355031 °1 ONE CIVIC SQUARE COMMUNITY OCCUPATIONAL HEALTH%k!ROK AMOUNT: $*******188.00* aq CARMEL, INDIANA 46032 7169 SOLUTION CENTER CHECK NUMBER: 320878 CHICAGO IL 60677-7001 CHECK DATE: 01/17/18 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1081 4340700 512366 188.00 MEDICAL FEES ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL VOUCHER NO. WARRANT NO. An invoice of bill to be properly itemized must show;kind of service,where performed,dates service rendered,by Vendor# 355031 Allowed 20 whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc. Community Occupational Health Services Payee 7169 Solution Center Chicago,IL 60677-7001 In Sum of$ Purchase Order# 355031 Community Occupational Health Services Terms $ 188.00 7169 Solution Center Date Due Chicago, IL 60677-7001 ON ACCOUNT OF APPROPRIATION FOR 108 ESE PO#or nvolce Description Dept# INVOICE NO. ACCT#ffITLE AMOUNT Invoice Date Number (or note attached invoice(s)or bill(s)) PO# Amount 1081-99 512366 4340700 $ 188.00 Board Members 1/3/18 512366 Pre-Employment Drug Testing xx6333 $ 188.00 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 $ 188.00 Total $ 188.00 January 11,2018 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 Con_murnty>OccupafionaIm 4&Nth Svs F� 71'69 Solution,Ce ter Chic�go�FIL, 606,7��7001 - Cay a Phone. 31"T-621=034,1,E FEIN: 35-1955223 Y JAN 0 8 1018 Invoice J'anualy03, 2Q18 Bill to: Lynn Russell For: Carmel Clay Parks &Recreation Carmel Clay Parks &Recreation 12/17 1411 E. 116th St. Carmel, IN 46032- � � nT C n1 vice#` 12�3;6.67 Proc Code Date Description Qty Charge Recei t Adjust Balance 746404 12/19/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Samantha Hovanec Balance Due: 47.00 746404 12/21/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Kendra C Mehringer Balance Due: 47.00 746404 12/19/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00. . 47.00 - Stephany Moreno-Balance Due: - - - - - _ 47.00_ __...... ..... - _. .. ....... ..— _. 746404 12/14/2017 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Catherine A O'Brien Balance Due: 47.00 -..._._._..........................._............._......................... ................._................_... Invoice# 512366 Balance DW!,,,.' ! 188 00 a �,rarr� x ., Please remit payment promptly