HomeMy WebLinkAbout323115 03/21/18 t°r_C4A'M
�. CITY OF CARMEL, INDIANA VENDOR: 355031
ONE CIVIC SQUARE COMMUNITY OCCUPATIONAL HEALTH(ghkOK AMOUNT: $"*****102.00*
?a CARMEL, INDIANA 46032 7169 SOLUTION CENTER CHECK NUMBER: 323115
9MiioN a� CHICAGO IL 60677-7001 CHECK DATE: 03/21/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4340799 517228 51.00- OTHER MEDICAL FEES
1120 4340799 518232 51.00 OTHER MEDICAL FEES
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
Vendor# 355031
COMMUNITY OCCUPATIONAL HEALTH SERVI IN SUM OF$ CITY OF CARMEL
7169 SOLUTION CENTER An invoice or bill to be properly itemized must show:kind of service,where performed,dates service
rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
CHICAGO, IL 60677-7001
Payee
$102.00
ON ACCOUNT OF APPROPRIATION FOR Purchase Order#
Carmel Fire Terms
Date Due
PO# ACCT# DATE INVOICE# DESCRIPTION
DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT
517228 43-407.99 $51.00 1 hereby certify that the attached invoice(s),or 3/17/18 517228 $51.00
1120 101 1120 101
518232 43-407.99 $51.00 bill(s)is(are)true and correct and that the 3/17/18 518232 $51.00
1120 101 1 materials or services itemized thereon for 1120 101
which charge is made were ordered and
received except
Saturday, March 17,2018
David Haboush
Fire Chief
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
120
Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer
Community Occupational Health Svs
7169 Solution Center
Chicago, IL 60677-7001
Phone: 317-621-0341
FEIN: 35-1955223
Invoice
February 15, 2018
Bill to: Accounts Payable For: Carmel Fire Department
City of Carmel 02/18
1 Civic Square
Carmel, IN 46032-
............ ........... ....... ................................ ............--......
Invoice# 517228
..........................
Proc Code ~ Date Description f Qty_ Charge Receipt Balance
80301 02/09/2018 Rapid 5 Panel UDS 1.00 51.00 51.00
Grant Russel XXX-XX-7484 Balance Due: 51.00
Invoice# 517228 Balance Due: 51.00
Please remit payment promptly
Cut and return with payment
-----------------------------------------------------------------------------------------------
Please remit 51.00 to Community Occupational Health Services
7169 Solution Center
Please place invoice number 517228 on check Chicago,IL 60677-7001
Phone: 317-621-0341
Community Occupational Health Svs
7169 Solution Center
Chicago, IL 60677-7001
Phone: 317-621-0341
FEIN: 35-1955223
Invoice
March 02, 2018
Bill to: Accounts Payable For: Carmel Fire Department
City of Carmel 02/18
1 Civic Square
Carmel, IN 46032-
Invoice# 518232
Proc Code Date Description Qty Charge Receipt Adiust _ Balance
80301 02/09/2018 Rapid 5 Panel UDS 1.00 51.00 51.00
John Jenkins XXX-XX-2662 Balance Due: 51.00
Invoice# 518232 Balance Due: 51.00
Please remit payment promptly