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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