HomeMy WebLinkAbout321410 02/07/18 1_Cgy
CITY OF CARMEL, INDIANA VENDOR: 355031
ONE CIVIC SQUARE COMMUNITY OCCUPATIONAL HEALTH GtIRQK AMOUNT: $********47.00*
CARMEL, INDIANA 46032 7169 SOLUTION CENTER CHECK NUMBER: 321410
CHICAGO IL 60677-7001 CHECK DATE: 02/07/18
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DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4340700 514288 47.00 MEDICAL FEES
ACCOUNTS PAYABLE VOUCHER
.CITY OF CARMEL
VOUCHER NO. WARRANT NO.
An invoice of bill to be properly itemized must show;kind of service,where performed,dates service rendered,by
Vendor# 355031 Allowed 20 whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
Community Occupational Health Services Payee
7169 Solution Center
Chicago, IL 60677-7001 In Sum of$ Purchase Order#
355031 Community Occupational Health Services Terms
$ 47.00 7169 Solution Center Date Due
Chicago, IL 60677-7001
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO#ornvolce Description
Dept# INVOICE NO. ACCT#!TITLE AMOUNT Invoice Date Number (or note attached invoices)or bill(s)) PO# Amount
1081-99 514288 4340700 $ 47.00 Board Members 1/16/18 514288 Pre-Employment Drug Testing xx6384 $ 47.00
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
$ 47.00 Total $ 47.00
February 1,2018
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
Co un p; t'�j `K-' Ith SVS
Soluficin1Center
;� ChcagoILG0677ry0g,1 ' 4r,
Phone. 317-62�=0341
FEIN: 35-1955223 JAN 1 9 2018
BY:
Invoice
VIM
Bill to: Lynn Russell For: Carmel Clay Parks &Recreation
Carmel Clay Parks &Recreation 01/18
1411 E. 116th St.
Carmel, IN 46032-
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,In�oi1VX 14288
Proc Cede- Date Description Q—t Charge Receipt Adiust Balance
746404 01/11/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Cassandra Deckert Balance Due: 47.00
Invoice# 514288 Balance Due: 47:00,
I
Please remit payment promptly
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