HomeMy WebLinkAbout328940 08/17/18 a°`'"qM
a;/ CITY OF CARMEL, INDIANA VENDOR: 355031
ONE CIVIC SQUARE COMMUNITY OCCUPATIONAL HEALTH%M-ROK AMOUNT: $*******235.00*
:�� f� CARMEL, INDIANA 46032 7169 SOLUTION CENTER CHECK NUMBER: 328940
y��9oN��°. CHICAGO IL 60677-7001 CHECK DATE: 08/17/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4340700 531395 235.00 MEDICAL FEES
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
VOUCHER NO. WARRANT NO.
An invoice of bill to be properly itemized must show;kind of service,where performed,dates service rendered,by
Vendor# 355031 Allowed 20 whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
Community Occupational Health Services Payee
7169 Solution Center
Chicago, IL 60677-7001 In Sum of$ 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 Fund
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 531395 4340700 $ 235.00 Board Members 8/2/18 531395 Pre-Employment Drug Testing xx7327 $ 235.00
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
$ 235.00 Total $ 235.00
August 15,2018
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 1PACHVlWKM
claim paid motor vehicle highway fund Signature 20_
Accounts Payable Coordinator Clerk-Treasurer
Title
Al' -ti Com'muhiOcc bona�HealthSvs
7169 Solution Cenfer
4 Chicago; 1� 606x77 77001
RECEIVED
Phone. 317=621-0341
FEIN: 35-1955223 AUG 0 9 2018
BY:
Invoice
Augusf 02;2018
Bill to: Lynn Russell For: Carmel Clay Parks &Recreation
Carmel Clay Parks &Recreation 07/18
1411 E. 116th St.
Carmel, IN 46032-
;: Invoice# 531-3'95
Proc Code Date Description Q—t Charge Receipt Adjust Balance
746404 07/17/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Aja J Huerkamp Balance Due: 47.00
_:...................._.. ........................_.. _......_....._............_._...._................_........................._._....._................
746404 07/19/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Dymond F Johnston Balance Due: 47.00
746404 07/25/2018 Drug Screen-Non NIDA 5 Panel. 1.00 47.00 - 47.00
James A Martin Balance Due: - 47.00
....._.__....... ...._._ ......... _.__.._.
746404 07/25/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Cameron S McNeely Balance Due: 47.00
-- .-----------........... _...... -------
746404 07/17/2018 DrugScreen-Non NIDA 5 Panel 1.00 47.00 47.00
Iyonna Sykes Balance Due: 47.00
Invoice# 531395 Balance Due: r 23'S41OQ<
Please remit payment promptly
�g LP