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HomeMy WebLinkAbout322439 03/05/18 D 1yCITY OF CARMEL, INDIANA VENDOR: 355031 ONE CIVIC SQUARE COMMUNITY OCCUPATIONAL HEALTH%k!RQK AMOUNT: S"".""94.00` CARMEL, INDIANA 46032 7169 SOLUTION CENTER CHECK NUMBER: 322439 CHICAGO IC 60677-7001 CHECK DATE: 03/05/18 � DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1081 4340700 517219 94.00 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 $ 94.00 7169 Solution Center Date Due Chicago, IL 66677-7001 ON ACCOUNT OF APPROPRIATION FOR 108-ESE PO#or INVOICE NO. ACCT#/TITLE AMOUNT Invoice Description Dept# Invoice Date Number (or note attached invoice(s)or bill(s)) PO# Amount 1081-99 517219 4340700 $ 94.00 Board Members 2/15/18 517219 Pre-Employment Drug Testing xx6509 $ 94.00 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 $ 94.00 Total $ 94.00 February 26,2018 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 Gobi urnurn rnty p fional=Healtf ;Svs 716.9 Solution Center �° E s'T F� Chicago;1L}60677 7001 *= Phone: 317-621-0341 FEB 2 2 203 FEIN: 35-1955223 Invoice �February_-1F5;_2018;, Bill to: Lynn Russell For: Carmel Clay Parks &Recreation Carmel Clay Parks &Recreation 02/18 1411 E. 116th St. Carmel, IN 46032- Inv0x0e#517219 Proc Code Date Description Q_yt Charge Receipt Adjust Balance 746404 02/13/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Donamarie V Kelley Balance Due: 47.00 746404 02/14/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Robert Wittig Balance Due: 47.00 Invoice# 517219 _ Please remit payment promptly