HomeMy WebLinkAbout334217 01/04/19 y ur_C�q�
,f. CITY OF CARMEL, INDIANA VENDOR: 355031
I; r1 ONE CIVIC SQUARE COMMUNITY OCCUPATIONAL HEALTH%URVK AMOUNT: $.......145.00*
CARMEL, INDIANA 46032 7169 SOLUTION CENTER CHECK NUMBER: 334217
MUTON�. CHICAGO IL 60677.7001 CHECK DATE: 01/04/19
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4340700 544223 98.00 MEDICAL FEES
1125 4340700 544223 47.00 MEDICAL FEES
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
VOUCHER NO. WARRANT NO.
An invoice of bill to be properly itemized must show;kind of service,where performed,dates service rendered,by
Vendor# 355031 Allowed 20_ whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
- Community Occupational Health Services Payee
7169 Solution Center
Chicago, IL 60677-7001 In Sum of$ 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#ornvoice Description
Dept# INVOICE NO. ACCT#/TITLE AMOUNT Invoice Date Number (or note attached invoice(s)or bill(s)) PO# Amount
1125 544223 4340700 $ 47.00 Board Members 12/17/18 544223 Pre-Employment Drug Tests xx7774 $ 47.00
1081-99 544223 4340700 $ 98.00 12/17/18 544223 Pre-Employment Drug Tests xx7774 $ 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
January 2,2019
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
claim paid motor vehicle highway fund Signature 20_
Accounts Payable Coordinator Clerk-Treasurer
Title
Coriamunity -66 'atio„naI Nealth—Svs
7169 ent
So tion Cer
Chita o'IL`60677-7001' q°o
rDEC
Phone: 317-621-0341
FEIN: 35-1955223 12010
Invoice
O dcember'1J,201-8
Bill to: Camille Nelsen For: Carmel Clay Parks &Recreation
Carmel Clay Parks &Recreation 12/18
1411 E. 116th St.
Carmel, IN 46032-
Inuoice# 544223
Proc Code Date Description QtV Chane Recei t Adjust Balance
746404 12/06/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Katelyn B Clock Balance Due: 47.00
_.........._..............._..__............. _......_..........__............._.. -............................_.._._............................................................
80101 12/07/2018 E-Screen Rapid UDS 5 Panel 1.00 51.00 51.00
Grant Fellabaum Balance Due: -51.00
746404 12/11/2018 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00
Jylian W Vigar Balance Due: 47.00
............. ............................. ............. ...... ...................
�Inuoce�# 54`4223�Balance�Dde � c� _�
Please remit payment promptly