HomeMy WebLinkAbout322017 02/19/18 '�Coq
4��.... ' CITY OF CARMEL, INDIANA VENDOR: 355031
d ONE CIVIC SQUARE COMMUNITY OCCUPATIONAL HEALTH QatIROK AMOUNT: S""`"329.00*
x CARMEL, INDIANA 46032 7169 SOLUTION CENTER CHECK NUMBER: 322017
k�(ION. ` CHICAGO IL 60677-7001 CHECK DATE. 02/19/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4340700 514737 282.00 MEDICAL FEES
1091 4340700 514737 ` 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
$ 329.00 7169 Solution Center Date Due
Chicago, IL 60677-7001
ON ACCOUNT OF APPROPRIATION FOR
108 ESE 1109 Monon Center
PD#ornvolce Description
Dept# INVOICE NO. ACCT#ffITLE AMOUNT Invoice Date Number (or note attached invoice(s)or bill(s)) PO# Amount
1081-99 514737 4340700 $ 282.00 Board Members 2/2/18 514737 Pre-Employment Drug Testing 50904 $ 282.00
1091 514737 4340700 $ 47.00 2/2/18 514737 Pre-Employment Drug Testing 50904 $ 47.00
1 hereby certify that the attached invoice(s),or
bili(s)is(are)true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
$ 329.00 Total $ 329.00
February 15,2018
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
CornLri unityOccupeitlon51--Health Svs
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Phone-`3-1`7=621=0341---�'
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Invoice
�ebrualy-Q2,�201-8�
Bill to: Lynn Russell For: Carmel Clay Parks &Recreation
Carmel Clay Parks &Recreation 01/18
1411 E. 116th St.
Carmel, IN 46032-
�In�rolce
Proc Code ICD Date Description QtV Charge Receipt Adiust Balance
746404 01/18/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Donny Andrews Balance Due: 47.00
......................._._..............._.........__..-......_.................._......_............._._......_....
746404 01/24/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Michelle-.Brown Balance Due: 47.00
-------------
746404
----------746404 01/18/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Katelyn Doan Balance Due: 47.00
._ ......._.... .-.__. ._.................................. ........................._._......
746404 01/31/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Kathleen Fairman Balance Due: 47.00
_..------ ...................... _._..-..._.......... _.......... ...... ------._.._..
746404 01/25/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Jasmine Hazelwood Balance Due: 47.00
746404 1) 01/16/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
S93.401A
2)Y93.39
Pamela Runyan Balance Due: 47.00
_... . ...... . . ..... . ..... ._._-.._ .. ..... ._.. ........... .._._... - ..
746404 01/22/2018 DrugScreen-Non NIDA 5 Panel 1.00 47.00 i 47.00
Caitlin E Stahl Balance Due: 47.00
----------------
Invoice# 514737 Balance Due:
329:0,0
Please remit payment promptly