HomeMy WebLinkAbout324750 04/30/18 4
CITY OF CARMEL, INDIANA VENDOR: 355031
ONE CIVIC SQUARE COMMUNITY OCCUPATIONAL HEALTH CkIROK AMOUNT: $******"141.00"
CARMEL, INDIANA 46032 7169 SOLUTION CENTER CHECK NUMBER: 324750
bM,TON: � CHICAGO:IL:60677-7001 CHECK DATE: 04/30/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4340700 522137 94.00 MEDICAL FEES
1091 4340700 522137 47.00 MEDICAL FEES
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
VOUCHER NO. WARRANT NO.
An invoice of bill to be properly itemized must show,kind of service,where performed,dates service rendered,by
Vendor# 355031 Allowed 20_ whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
Community Occupational Health Services Payee
7169 Solution Center
Chicago, IL 60677-7001 In Sum of$ Purchase Order#
355031 Community Occupational Health Services Terms
$ 141.00 7169 Solution Center Date Due
Chicago, IL 60677-7001
ON ACCOUNT OF APPROPRIATION FOR
108-ESE 1109 Monon Center
PO#ornvoice Description
Dept# INVOICE NO. ACCT#lrITLE AMOUNT Invoice Date Number (or note attached invoice(s)or bill(s)) PO# Amount
1081-99 522137 4340700 $ 94.00 Board Members 4/16/18 522137 Pre-Employment Drug Testing xx6762 $ 94.00
1091 522137 4340700 $ 47.00 4/16/18 522137 Pre-Employment Drug Testing xx6762 $ 47.00
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
$ 141.00 Total $ 141.00
April 24,2018
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 1pkhlltm�—
claim paid motor vehicle highway fund Signature -,20_
Accounts Payable Coordinator Clerk-Treasurer
Title
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Chgcago,�IL!-60�67 -7001
A P f2 1 9 2018 317 62,1�03�41
FEIN: 35-1955223
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Invoice
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Bill to: Lynn Russell For: Carmel Clay Parks &Recreation
Carmel Clay Parks &Recreation 04/18
1411 E. 116th St.
Carmel, IN 46032-
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Proc Code ICD Date Description Qty Charge Receipt Adjust Balance
746404 04/11/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Graham C Hatfield Balance Due: 47.00
746404 04/11/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Claire L Labus Balance Due: 47.00
746404 1)M54.5 04/06/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
2)
S83.402A
Haley Liston Balance Due: 47.00
Invoic #,��52�°1F37 Bal'an a D;ue� � • a�"�, �L4100 -
Please remit payment promptly
4419
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