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HomeMy WebLinkAbout323299 03/23/18 CITY OF CARMEL, INDIANA VENDOR: 355031 8 '1 ONE CIVIC SQUARE COMMUNITY OCCUPATIONAL HEALTH%k!RoK AMOUNT: $*******235.00* ate; CARMEL, INDIANA 46032 7169 SOLUTION CENTER CHECK NUMBER: 323299 yy`TON,LO� CHICAGO IL 60677-7001 CHECK DATE: 03/23/18 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1081 4340700 519403 235.00 MEDICAL FEES ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL VOUCHER NO. WARRANT NO. An invoice of bill to be properly itemized must show;kind of service,where performed,dates service rendered,by Vendor# 355031 Allowed 20 whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc. Community Occupational Health Services Payee 7169 Solution Center Chicago, IL 60677-7001 In Sum of$ Purchase order# 355031 Community Occupational Health Services Terms $ 235.00 7169 Solution Center Date Due Chicago, IL 60677-7001 ON ACCOUNT OF APPROPRIATION FOR 108-ESE PO#ornvoice Description Dept# INVOICE NO. ACCT#/TITLE AMOUNT Invoice Date Number (or note attached invoice(s)or bill(s)) PO# Amount 1081-99 519403 4340700 $ 235.00 Board Members 3/15/18 519403 Pre-Employment Drug Testing xx6614 $ 235.00 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 $ 235.00 Total $ 235.00 March 19,2018 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 Community'01 - I ational-Hea� l S s '4 71:69 Soltafion Center" , Chicago` 00 '1 Phone: 317-621-0341 ? 7 FIR, FEIN: 35-1955223 MAR 1 9 2010 BY............................_ �IVlareh1�5, 2�0�18 Bill to: Lynn Russell For: Carmel Clay Parks &Recreation Carmel Clay Parks &Recreation 03/18 1411 E. 116th St. Carmel, IN 46032- 4"Inuolce�# ;5519403 Proc Code Date Description City Charge Receipt Adjust Balance 746404 03/14/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Emily R Berling Balance Due: 47.00 746404 03/14/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Nicole R Cortelyou Balance Due: 47.00 746404 03/07/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Hannah D Gretz Balance Due: 47.00 746404 03/14/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Kaelin A Krull Balance Due: 47.00 746404 03/14/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Kalie D Sites Balance Due: 47.00 Invoice# 519403 a'IanceDue s k `X ya "` Y '�� 23.5.00 Please remit payment promptly Cut and return with navment