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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