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HomeMy WebLinkAbout326495 06/20/18 ,1 pI C�qM� / �� CITY OF CARMEL, INDIANA VENDOR: 355031 ,• ONE CIVIC SQUARE COMMUNITY OCCUPATIONAL HEALTH�f4K AMOUNT: $*****1,128.00* f. �� CARMEL, INDIANA 46032 7169 SOLUTION CENTER CHECK NUMBER: 326495 9M„TON�o` CHICAGO IL 60677-7001 CHECK DATE: 06/20/18 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1081 4340700 525359 1,128.00 MEDICAL FEES ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL VOUCHER NO. WARRANT NO. An invoice of bill to be properly itemized must show;kind of service,where performed,dates service rendered,by Vendor# 355031 Allowed 20 whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc. Community Occupational Health Services Payee 7169 Solution Center Chicago, IL 60677-7001 In Sum of$ Purchase Order# 355031 Community Occupational Health Services Terms $ 1,128.00 7169 Solution Center Date Due Chicago, IL 60677-7001 ON ACCOUNT OF APPROPRIATION FOR 108-ESE Fund PO#ornvoice Description Dept# INVOICE NO. ACCT#!TITLE AMOUNT Invoice Date Number (or note attached invoice(s)or bill(s)) PO# Amount 1081-99 525359 4340700 $ 1,128.00 Board Members 6/4/18 525359 Pre-Employment Drug Testing 51528 $ 1,128.00 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 $ 1,128.00 Total $ 1,128.00 June 12,2018 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 claim paid motor vehicle highway fund Signature 20_ Accounts Payable Coordinator Clerk-Treasurer Title Community Occupational Health Svs t ti 7169 Solution Center Chicago, IL 60677-7001 Phone: 317-621-0341 �I-XV ris D FEIN: 35-1955223 JUN 6 2018 Y, Invoice J. ne 04, 2 Bill to: Lynn Russell For: Carmel Clay Parks &Recreation Carmel Clay Parks &Recreation 05/18 1411 E. 116th St. Carmel, IN 46032- Invoice# 525359 Proc Code Date Description Q_yt Charge Receipt Adjust Balance 746404 05/30/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Samantha Ardery Balance Due: 47.00 ..........__........................._........................_......-....................._...............................__,..........................._.............................__.......... 746404 05/28/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Haley C Beach Balance Due: 47.00 746404 05/21/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 4.7.00 Katherine M Bentivoglio Balance Due: -47.00- ............ 47.00...._.._ _. _ .. .._...... ....__......-_._... ._...._.._....... 746404 05/30/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Samantha C Bentivoglio Balance Due: 47.00 ................ _._. 746404 05/22/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 David Bergsma Balance Due: 47.00 ..........._...._ ................_._......................__.._..............................._..._......._.. 746404 05/19/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Davis Botta Balance Due: 47.00 - 746404 05/22/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Michael S Bray Balance Due: 47.00 746404 05/12/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Felicia R Diaz Balance Due: 47.00 ... .......__ ......................... ............ .._ _.. ......... 746404 05/14/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Nate S Duncan Balance Due: 47.00 -- --- ------- ------ ----- ------- ---------- --------- ----- ---- - - ------ - - - 746404 05/29/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 William Fesler Balance Due: 47:00 7464.04 05/16/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Alex Galand Balance Due: 47.00 ...._..____-....___._- 746404 05/24/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Invo1ce# 525359. (co itiriued;page 2 Lilllian Green Balance Due: 47.00 746404 05/23/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Abby Hamachek Balance Due: 47.00 .............. 746404 05/15/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Kayla Hauck Balance Due: 47.00 ...........__.........................__. ....... .................._._..._.._.... .. .......... ....._._._.. .. 746404 05/25/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Hannah M Klineman Balance Due: 47.00 _.. ......_ .. ._..__.. ._.... - ---.__ _.. ..... __...-. .___.... 746404 05/23/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Jennifer Lucero Balance Due: 47.00 _........._.....:_.. - ...........__..._.._._._.__ ...... 746404 05/23/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Ronald L Patterson Balance Due: 47.00 746404 05/22/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Mary Pedrick Balance Due: 47.00 . ....._ ....-..- _._._..... .......... _ ....... 746404 05/22/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 JESSICA M SCHRADER Balance Due: 47.00 .. ......_....---- _ ........_ ..._._... ......._ 746404 05/15/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Jessica K Schutz Balance Due: 47.00 ----- - ----------------------- ------------------ ------- -- ------- -- ------ - - 746404 05/16/2018 DrugScreen-Non NIDA 5 Panel 1.00 47.00 47.00 Madison A Shaffer Balance Due: 47.00 - 746404 05/14/2018 Drug -----..............................--------........_.. .._............-- Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Patrick L Taylor Balance Due: 47.00 ------------- -------- ----------- -------._.._.._----------------- ------------- 746404 ---------746404 05/24/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Kayla L Walker Balance Due: 47.00 - __ ......... ...__ .__ 746404 05/22/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Alyssa L Yerkeson Balance Due: 47.00 In�o�e"#�5253'S9 BalancegDiie`b��"'q '�' '` 1e12�0'0� Please remit payment promptly Lk Cut and return with payment