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
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