HomeMy WebLinkAbout322992 03/21/18 `Cqq
CITY OF CARMEL, INDIANA VENDOR: 355031
ONE CIVIC SQUARE COMMUNITY OCCUPATIONAL HEALTH% ROK AMOUNT: $'""""282.00'
r ?� CARMEL, INDIANA 46032 7169 SOLUTION CENTER CHECK NUMBER: 322992
vy, CHICAGO IL 60677-7001 CHECK DATE: 03/21/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4340700 518216 282.00 MEDICAL FEES
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
VOUCHER NO. WARRANT NO.
An invoice of bill to be properly itemized must show;kind of service,where performed,dates service rendered,by
Vendor# 355031 Allowed 20 whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
Community Occupational Health Services Payee
7169 Solution Center
Chicago, IL 60677-7001 In Sum of$ Purchase Order#
355031 Community Occupational Health Services Terms
$ 282.00 7169 Solution Center Date Due
Chicago, IL 60677-7001
ON ACCOUNT OF APPROPRIATION FOR
108-ESE
PO#or Invoice Description
Dept# INVOICE NO. ACCT#/TITLE AMOUNT Invoice Date Number (or note attached invoice(s)or bill(s)) PO# Amount
1081-99 518216 4340700 $ 282.00 Board Members 3/2/18 518216 Pre-Employment Drug Testing 51026 $ 282.00
1 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
$ 282.00 Total $ 282.00
March 12,2018
I 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
20_Accounts Payable Coordinator Clerk-Treasurer
Title
Community OccupationalHealth Sv
p � 7169 Solution Center
Chicago, IL 60677-700
Phohe�"3"17`621 0341
-FEIN: 35-1955223
MAR 0 8 2018
BY:
Invoice
Niyarch.02, 2018
Bill to: Lynn Russell For: Carmel Clay Parks & Recreation
Carmel Clay Parks &Recreation '02/i18
1411 E. 116th St.
Carmel, IN 46032-
__
1nry
oiM#,,-,%5:182-16
Proc Code Date Description Qty Charge Receipt Adiust Balance
746404 02/26/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Diana S King Balance Due: 47.00
746404 02/22/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Matthew S Macke Balance Due: 47.00
746404 02/22/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Maya Mash Balance Due: 47.00
746404 02/21/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Rachel McDanell Balance Due: 47.00
746404 02/21/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Nisha Singh Balance Due: 47.00
746404 02/23/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Grant Syrek Balance Due: 47.00
Invoice'# 5�1�82?16 Balance.Due��r � 282,00
Please remit payment promptly