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