HomeMy WebLinkAbout330675 10/02/18 CITY OF CARMEL, INDIANA VENDOR: 355031
a.
® I, ONE CIVIC SQUARE COMMUNITY OCCUPATIONAL HEALTH%UftQK AMOUNT: $......
s_ CARMEL, INDIANA 46032 7169 SOLUTION CENTER CHECK NUMBER: 330675
CHICAGO IL 60677-7001
„oN�• CHECK DATE: 10/02/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4340700 533583 329.00 MEDICAL FEES
1125 4340700 533583 47.00 MEDICAL FEES
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
VOUCHER NO. WARRANT NO.
An invoice of bill to be properly itemized must show;kind of service,where performed,dates service rendered,by
Vendor# 355031 Allowed 20_ whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
Community Occupational Health Services Payee
7169 Solution Center
Chicago, IL 60677-7001 In Sum of$ Purchase Order#
355031 Community Occupational Health Services Terms
$ 376.00 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 533583 4340700 $ 47.00 Board Members 9/5/18 533583 Pre-Employment Drug Testing 51920 $ 47.00
1081-99 533583 4340700 $ 329.00 9/5/18 533583 Pre-Employment Drug Testing 51920 $ 329.00
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
$ 376.00 Total $ 376.00
September 25,2018
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 1pkjttm��
claim paid motor vehicle highway fund Signature _,20_
Accounts Payable Coordinator Clerk-Treasurer
Title
SEP/21/2018/FRI 12;59 PM VEI CBO FAX No. 317-621-0301 P. 002
Co mu ,y Occupational 4eafth Svs
7189'Solutlon Genfer�
Chicago,-IC-60677-7001 �� 5 e
Phone;317-6210341
FEIN: 35-1955223
Invoice
September-p5;2018
Bill to: Lynn Russell For: Carmel Clay Parks&Recreation
Carmel Clay Parks &Recreation 08/18
1411 B. 116th St.
Carmel, IN 46032-
Invoice#533583
Proc Code ICD Date Description City Charge Receipt dust Balance
746404 08/15/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47,00
Robert Anderson Balance Due: 47.00
746404 08/22/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Jisette N Blondet Balance Due: 47,00
746404 08/15/2018 Drog Screen-Non NIDA 5 Panel 1.00 47.00 47,00
Michelle M Carroll Balance Due: 47,00
746404 08/22/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Lily K Oneil Balance Due: 47.00
746404 1 08/17/2018 Drug Screen-Non NIDA 5 Panel 1100 47.00 47.00
S80.10XA
2)
W01,198A
Richard.1 Ranstord Balance Due: 47.00
746404 08/29/2018 Drug Screen-Non NIDA 5 Panel 1.00 47,00 47.00
Ashley N Salina$Balance Due: 47,00
746404 08/16/2018 Drug Screen-Non NIDA 5 Panel 1.00 47,00 47.00
Destrae E Spille Balance Due: 47.00
746404 08/15/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Deja Thomas Balance Doe; 47,00
Inwo-i e H 01983 Balance Due- O 0-
Please
Please remit payment promptly
SEP/21/2018/FRI 12;59 PM VEI CBO FAX No. 317-621-0301 P. 003
Invoice# X335$3 (continued)page 2