HomeMy WebLinkAbout331310 10/17/18 %���� CITY OF CARMEL, INDIANA VENDOR: 355031
���® 3. ONE CIVIC SQUARE COMMUNITY OCCUPATIONAL HEALTH%Nj9K AMOUNT: $********94.00*
:9� ��� CARMEL, INDIANA 46032 7169 SOLUTION CENTER CHECK NUMBER: 331310
.y��TON�°' CHICAGO IL 60677-7001 CHECK DATE: 10/17/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4340700 537112 94.00 MEDICAL FEES
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
VOUCHER NO. WARRANT NO.
An invoice of bill to be properly itemized must show;kind of service,where performed,dates service rendered,by
Vendor# 355031 Allowed 20 whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
Community Occupational Health Services Payee
7169 Solution Center
Chicago, IL 60677-7001 In Sum of$ Purchase Order#
355031 Community Occupational Health Services Terms
$ 94.00 7169 Solution Center Date Due
Chicago, IL 60677-7001
ON ACCOUNT OF APPROPRIATION FOR
108-ESE Fund
Po#ornvolce Description
Dept# INVOICE NO. ACCT#lrITLE AMOUNT Invoice Date Number (or note attached invoice(s)or bill(s)) PO# Amount
1081-99 537112 4340700 $ 94.00 Board Members 10/2/18 537112 Pre-Employment Drug Testing xx7519 $ 94.00
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
$ 94.00 Total $ 94.00
October 10,2018
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
Community Occupational Health Svs
7169 Solution Center
Chicago, IL 60677-7001
Phone: 317-621-0341
FEIN: 35-1955223
.�iN
t 7 7lip
OCT 092018
Invoice BY:
ctobe �2,;2.4�18;hy.
Bill to: Lynn Russell For: Carmel Clay Parks &Recreation
Carmel Clay Parks &Recreation 9/18
1411 E. 116th St.
Carmel, IN 46032-
nvoice
Proc Code Date Description Q_yt Charge Receipt Adigg Balance
746404 09/21/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Kimberly Caldwell Balance Due: 47.00
..................._......_.---------------.............................__.._..............
746404 09/20/2018 DrugScreen-Non NIDA 5 Panel 1.00 47.00 47.00
Judy Meiklejohn Balance Due: 47.00
..............................................................._......_........
nvo ce# 5:711ance`llue g4a
Please remit payment promptly
C..nt AM—h—with--t