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Home My WebLink About158845 04/30/2008 CITY OF CARMEL, INDIANA VENDOR 355031 Page 1 of 1 ONE CIVIC SQUARE COMMUNITY OCCUPATIONAL HEALTH gER CARMEL, INDIANA 46032 P 0 BOX 19383 CHE�K AMOUNT: $1,462.00 INDIANAPOLIS IN 46219 CHECK NUMBER. 158845 CHECK DATE: 4130/2008 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1046 4340700 207346 473.00 MEDICAL FEES 1047 4340700 207346 903.00 MEDICAL FEES 1125 4340700 207346 86.00 MEDICAL FEES 1 I l Community Occupational Health Services P O Box 19383 t Indianapolis, IN 46219 317- 355 -6335 Tax ID 35- 1955223 7 cEIVED APR 7 2008 Invoice 1 8 y, April 02, 2008 3t11 to: Lynn Russell m For: Car el Clay Parks Recreation Carmel Clay Parks Recreation 3/08 1411 E. 116th St. Carmel, IN 46032- Invoice 4 207346 Proc Code Service Date Description Quantity Charge Recei Balance 30101 03/11 /2008 Drug Screen -Non NIDA 5 Panel 1 00 43 00 4300 John R Balance Due: 43.00 M101 03;25/2008 Drug Screen Non NIDA 5 Panel 1 00 43 00 43 00 LaTonia A Alexander- Booker Balance Due: 43.00 °0101 03-•26/2008 Drug Screen Non NIDA 5 Panel 1 00 4300 4300 Lindsay V Atkinson Balance Due: 43.00 -0101 03/17!2008 Drug Screen Non NIDA 5 Panel 1 00 4300 4300 Natasha Berry � Balance Due: 43.00 80101 031 11 Ding Screen Non NIDA 5 Panel 100 4300 4300 i Emily M Brown Balance Due: 43.00 30101 03 10/2008 Drug Screen Non NIDA 5 Panel 1 00 4300 4300 Stacy A Brown - Balance Due: 43.00 _)101 03122 %2008 Dnrg Screen Non NIDA 5 Panel 1 00 4300 4300 Allison Chadwick Balance Due: 43.00 40101 031 Ding Screen Non NIDA 5 Panel 1 00 43.00 43 00 Isaac S Duncan Balance Due: 43.00 Invoice 207346 (continued) page 2 Proc Code Service Date Description Quantity Charge Receipt Adjust Balance 80101 03;24; 2008 Drug Screen Non NIDA 5 Panel 1 00 4300 43 00 Denise DExford4lMM0620 Balance Due: 43.00 50101 03,'05%2008 Drua Screen Non NIDA 5 Panel 1 00 43 00 43 00 David T Fos Balance Due: 43.00 80101 03-'01/ Drug Screen Non NIDA 5 Panel 1 00 43 00 43 00 Laura E Gettelfinger Balance Due: 43.00 80101 03!27112008 Drug Screen Non \TIDA 5 Panel 1 00 43 00 4300 Laura L Goar Balance Due: 43.00 031 Drug Screen Non NIDA 5 Panel 100 4300 43 00 Mmberly D Hamer Balance Due: 43.00 80101 03 %25,'2008 DnTff Screen Non \TIDA 5 Panel 1.00 43.00 4300 Bailee J Hillis Balance Due: 43.00 80101 03/128/12008 Drug Screen Non NIDA 5 Panel 1 00 43 00 43 00 Jack W James Balance Due: 43.00 80101 031 DruQ Screen Non NIDA 5 Panel 1 00 4300 43 00 Na H Kang Balance Due: 43.00 80101 03'29 %2008 Drug Screen Non NIDA 5 Panel 1 00 4300 43 00 Joseph J Kartholl Balance Due: 43.00 10 Drug Screen -Non NIDA 5 Panel 1.00 4300 4300 Shannon M Kinser Balance Due: 43.00 80101 03/20/12008 Drut Screen Non NIDA 5 Panel 1.00 43 00 i 4300 Robbyn Kizer Balance Due: 43.00 80101 03%02.2008 Drug Screen Non NIDA 5 Panel 100 4300 43 00 Shelby K Kroeger Balance Due: 43.00 80101 012-5/2008 Drug Screen Non NIDA 5 Panel 1 00 4300 43 00 Tara L Laird Balance Due: 43.00 L; Invoice 207346 (continued) page 3 Proc Code Service Date Description Quantitv Charge Receipt Adjust Balance 30101 03 %10;`2008 Drug Screen Non NIDA 5 Panel 1 00 43.00 43 00 Oreille L Massingill Balance Due: 43.00 00101 031, Drug Screen -Non NIDA 5 Panel 1 00 43 00 43 00 Birgitta R Monson ( Balance Due: 43.00 80101 03128 %2008 Drug Screen Non NIDA 5 Panel 1 00 4300 43 00 Amber K Obert Balance Due: 43.00 80101 03/24/2008 Drug Screen Non NIDA 5 Panel 100 43 00 43.00 f Ashley N Pennington Balance Due: 43.00 1 )0101 03 %02/2008 Dru4 Screen Non NIDA 5 Panel 1 00 4300 43 00 Alison L Pont Balance Due: 43.00 30101 03 %24!2008 Drug Screen Non NIDA 5 Panel 100 4300 43.00 Olivia K Povnter - Balance Due: 43.00 80101 03112 %2008 Dru( Screen Non NIDA 5 Panel 1 00 43.00 43 00 David S Raab - Balance Due: 43.00 90101 03/15/2008 Dnrg Screen Non NIDA 5 Panel 1 00 43.00 1 43 00 Dena M Rabie Balance Due: 43.00 80101 03 %29!2008 Drug Screen -Non NIDA 5 Panel 1 00 4300 43 00 Sarah E Shaw Balance Due: 43.00 W101 03'141:2008 Drug Screen Non NIDA 5 Panel 1 00 4300 43.00 Katherine E Sheets Balance Due: 43.00 80101 03/18/2008 DruE Screen Non NIDA 5 Panel 100 4300 f 4300 Sadie L Silcox Balance Due: 43.00 r------------------------------------------------------------------------------------------------------------------ t 80101 03 29,'2008 Drug Screen Non NIDA 5 Panel 1 00 4300 4300 R an D Yost Balance Due: 43.00 80101 03/27%2008 Drug Screen Non NIDA 5 Panel 100 43 00 43 00 ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice of bill to be properly itemized must show, kind of service, where performed, dates service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc Payee Purchase Order No 355031 Community Occupational Health Services Terms PO Box 19383 Date Due Indianapolis, IN 46219 Invoice Invoice I Description Date Number or note attached invoice(s) or bill(s)) Amount 02- Apr -08 207346 Employment drug testing 1,46200 I I I Total 1,462.00 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 20_ Clerk- Treasurer Voucher No Warrant No 355031 Community Occupational Health Services Allowed 20 PO Box 19383 Indianapolis, IN 46219 In Sum of R 1,462.00 ON ACCOUNT OF APPROPRIATION FOR 104 101 PO# or Board Members Dept I INVOICE NO (ACCT #/TITLEl AMOUNT 1125 I 207346 I 4340700 I 8600 1 hereby certify that the attached invoice(s), or 1046 I 207346 I 4340700 I 47300 bill(s) is (are) true and correct and that the 1047 I 207346 I 4340700 I 90300 materials or services itemized thereon for which charge is made were ordered and received except I I 22 -Apr 2008) I I =Se 1,462.00 Busin des Manager Cost distribution ledger classification if Title claim paid motor vehicle highway fund