HomeMy WebLinkAbout326566 06/28/18 �/ CITY OF CARMEL, INDIANA VENDOR: 355031
ONE CIVIC SQUARE COMMUNITY OCCUPATIONAL HEALTH tMFOK AMOUNT: $*******188.00*
s +`: CARMEL, INDIANA 46032 7169 SOLUTION CENTER CHECK NUMBER: 326566
v�`ioN,�� CHICAGO IL 60677-7001 CHECK DATE: 06/28/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4340700 527099 188.00 MEDICAL FEES
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
VOUCHER NO. WARRANT NO.
An invoice of bill to be properly itemized must show;kind of service,where performed,dates service rendered,by
Vendor# 355031 Allowed 20_ whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
Community Occupational Health Services Payee
7169 Solution Center
Chicago, IL 60677-7001 In Sum of$ Purchase Order#
355031 Community Occupational Health Services Terms
$ 188.00 7169 Solution Center Date Due
Chicago, IL 60677-7001
ON ACCOUNT OF APPROPRIATION FOR
108-ESE Fund
PO#or INVOICE NO. ACCT#(rITLE AMOUNT Invoice Description
Dept# Invoice Date Number (or note attached invoice(s)or bill(s)) PO# Amount
1081-99 527099 4340700 $ 188.00 Board Members 6/15/18 527099 Pre-Employment Drug Testing xx7093 $ 188.00
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
$ 188.00 Total $ 188.00
June 21,2018
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
Communit O ion alth Svs
C7;11,69 Sol"ution C—En%,
hicag, IL�606777c0:01
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JUN202010
BY:
,Gees
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Bill to: Lynn Russell For: Carmel Clay Parks &Recreation
Carmel Clay Parks &Recreation 06/18
1411 E. 116th St.
Carmel, IN 46032- _
In�o270993
Proc Code Date Description Qty Charge Receipt Adiust Balance
746404 06/04/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
HANNAH M ARBUCKLE Balance Due: 47.00
................................_................
746404 06/04/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Logan Burgess Balance Due: 47.00
746404 06/04/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
EMILY E GARMAN Balance Due: 47.00
_.........__........ ........... ..................... ......... ......
746404 06/04/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
BRYANT A YAU Balance Due: 47.00
Invoice# 527099 Balance Due: IggpO�
Please remit payment promptly
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