HomeMy WebLinkAbout329614 09/05/18 (9)
CITY OF CARMEL, INDIANA VENDOR: 355031
ONE CIVIC SQUARE COMMUNITY OCCUPATIONAL HEALTH CgfOK AMOUNT: $*******145.00*
CARMEL, INDIANA 46032 7169 SOLUTION CENTER CHECK NUMBER: 329614
CHICAGO IL 60677-7001 CHECK DATE: 09/05/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4340700 533019 98.00 MEDICAL FEES
1125 4340700 533019 47.00 MEDICAL FEES
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
VOUCHER NO. WARRANT NO.
An invoice of bill to be properly itemized must show;kind of service,where performed,dates service rendered,by
Vendor# 355031 Allowed 20 whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
Community Occupational Health Services Payee
7169 Solution Center
Chicago, IL 60677-7001 In Sum of$ Purchase Order#
355031 Community Occupational Health Services Terms
$ 145.00 7169 Solution Center Date Due
Chicago, IL 60677-7001
ON ACCOUNT OF APPROPRIATION FOR
101 General Fund/108 ESE
PO#or nvolce Description
Dept# INVOICE NO. ACCT#!TITLE AMOUNT Invoice Date Number (or note attached invoice(s)or bill(s)) PO# Amount
1125 533019 4340700 $ 47.00 Board Members 8/15/18 533019 Pre-Employment Drug Testing xx7362 $ 47.00
1081-99 533019 4340700 $ 98.00 8/15/18 533019 Pre-Employment Drug Testing xx7362 $ 98.00
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
$ 145.00 Total $ 145.00
August 24,2018
1 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
Co unity`Occupation—grHealth Svs
" 1`69 Solution Center-
Chicago,'IL 6'0677-700.1
Phone 317 621.6ZC
FEIN. 35-1955223
AUb 2 0 1010
Y:
Invoice
2ggust 115;2018
Bill to: Lynn Russell For: Carmel Clay Parks & Recreation
Carmel Clay Parks &Recreation 08/18
1411 E. 116th St.
Carmel, IN 46032-
Invoke#533019
Proc Code Date Description Qty Charge Receipt Adiust Balance
746404 08/08/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Michelle Applegate Balance Due: 47.00
746404 08/06/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Brooke Buttars Balance Due: 47.00
80101 08/06/2018 E-Screen Rapid UDS 5 Panel 1.00 51.00 51.00
Nathan P Morales Balance Due: 51.00
r"Inyoice-#_533019-Balance-Due: 1.a�00
Please remit payment promptly