HomeMy WebLinkAbout324124 04/18/18 1��.�Aq,,f. CITY OF CARMEL, INDIANA VENDOR: 355031
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ONE CIVIC SQUARE COMMUNITY OCCUPATIONAL HEALTH QldAQK AMOUNT: $*******141.00*
?�; CARMEL, INDIANA 46032 7169 SOLUTION CENTER CHECK NUMBER: 324124
1!1"' , CHICAGO IL 60677-7001 CHECK DATE: 04/18/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1061 4340700 520593 94.00 MEDICAL FEES
1125 4340700 520593 47.00 MEDICAL FEES
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
VOUCHER NO. WARRANT NO.
An invoice of bill to be properly itemized must show;kind of service,where performed,dates service rendered,by
Vendor# 355031 Allowed 20 whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
Community Occupational Health Services Payee
7169 Solution Center
Chicago, IL 60677-7001 In Sum of$ Purchase Order#
355031 Community Occupational Health Services Terms
$ 141.00 7169 Solution Center Date Due
Chicago, IL 60677-7001
ON ACCOUNT OF APPROPRIATION FOR
101 General Fund/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 520593 4340700 $ 94.00 Board Members 4/3/18 520593 Pre-Employment Drug Testing xx6686 $ 94.00
1125 520593 4340700 $ 47.00 4/3/18 520593 Pre-Employment Drug Testing xx6686 $ 47.00
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
$ 141.00 Total $ 141.00
April 10,2018
I hereby certify that the attached invoice(s),or bill(s)is(are)true and correct and I have audited same in accordance
l� with IC 5-11-10-1.6
Cost distribution ledger classification if �/'
kjV&W1J-KM
claim paid motor vehicle highway fund Signature 20_
Accounts Payable Coordinator Clerk-Treasurer
Title
tCorimumity Occupati6natYea I
1QQQ91S.617tj_a.n Center.
317-621-0341 11 r K 0 6 2018
FEIN: 35-1955223
LEI—.
Invoice
Bill to: Lynn Russell For: Carmel Clay Parks &Recreation
Carmel Clay Parks &Recreation 03/18
1411 E. 116th St.
Carmel, IN 46032-
Proc Code Date Description QtV Charge Receipt Adjust Balance
746404 03/27/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Timothy Allen Balance Due: 47.00
.......... ..............
746404 03/20/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Tera Bbtta Balance Due: 47.00
......................
746404 03/15/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Brad Webster Balance Due:- 47-.00
Please remit payment promptly
Cnt and return with navrnent