HomeMy WebLinkAbout331705 10/30/18 CITY OF CARMEL, INDIANA VENDOR: 355031
• ONE CIVIC SQUARE COMMUNITY OCCUPATIONAL HEALTH%NFOK AMOUNT: $********47.00*
CARMEL, INDIANA 46032 7169 SOLUTION CENTER CHECK NUMBER: 331705
CHICAGO IL 60677-7001 CHECK DATE: 10/30/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4340700 538904 47.00 MEDICAL FEES
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
VOUCHER NO. WARRANT NO.
An invoice of bill to be properly itemized must show;kind of service,where performed,dates service rendered,by
Vendor# 355031 Allowed 20_ whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
Community Occupational Health Services Payee
7169 Solution Center
Chicago, IL 60677-7001 In Sum of$ Purchase Order#
355031 Community Occupational Health Services Terms
$ 47.00 7169 Solution Center Date Due
Chicago, IL 60677-7001
ON ACCOUNT OF APPROPRIATION FOR
108-ESE Fund
PO#or INVOICE NO. ACCT WTITLE AMOUNT Invoice Description
Dept# Invoice Date Number (or note attached invoice(s)or bill(s)) PO# Amount
1081-99 538904 4340700 $ 47.00 Board Members 10/15/18 538904 Pre-Employment Drug Testing $ 47.00
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
$ 47.00 Total $ 47.00
October 22,2018
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 1PAh4WLMjA)
claim paid motor vehicle highway fund Signature -,20_
Accounts Payable Coordinator Clerk-Treasurer
Title
Community.Occupatior'--Heal Sus
7169 Solufion,,ECe�„rter�,
Chicago_
On
Phone:
Phone: 317-621-0341
FEIN: 35-1955223 RE C r IVSD
OCT 1 9 2018
BX:.
.............................
Invoice
�'cfio 6 eT5��201a8.t--�
Bill to: Lynn Russell For: Carmel Clay Parks &Recreation
Carmel Clay Parks &Recreation 9/18
1411 E. 116th St.
Carmel, IN 46032-
oce�#�a5y389�.®?F;�
Proc Code Date Description QQt rr Charge Receipt Adi Balance
746404 09/25/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
MONIECE JONES Balance Due: 47.00
Invoice# 538904 alance Due: 4 ;
Please-remit payment promptly