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Home My WebLink About155688 01/23/2008 i CITY OF CARMEL, INDIANA VENDOR 355031 Page 1 of 1 ONE CIVIC SQUARE COMMUNITY OCCUPATIONAL HEALTH CARMEL, INDIANA 46032 P 0 BOX 19383 K AMOUNT: $2,191.00 INDIANAPOLIS IN 46219 CHECK NUMBER: 155688 CHECK DATE: 1/23/2008 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1047 4340700 196912 1,183.00 MEDICAL FEES 1046 4340700 199068 168.00 MEDICAL FEES 1046 4340700 201295 126.00 MEDICAL FEES 1047 4340700 201295 630.00 MEDICAL FEES 1125 4340700 201295 84.00 MEDICAL FEES i j 1 i Community Occupational Health Services P.O Box 19383 Indianapolis, IN 46219 4 317- 355 -6335 Tax ID 35- 1955223 X7 JAN 0 8 2008 I Invoice BY: J January 03, 2008 Bill to: Lynn Russell For: Carmel Clay Parks Recreation Carmel Clay Parks Recreation Dec 2007 1411 E. 116th St. Cannel, IN 46032- Inv 20 1295 Proc Code Service Date Description Quantity Charge Receipt Haiust balance 80101 12/11/2007 Drug Screen Non NIDA 5 Panel 1.00 42.00 42.00 David N Bittelmeyer Balance Due: 42.00 80101 12/29/2007 Drug Screen Non NIDA 5 Panel 1.00 42.00 4200 Nathan R Conley Balance Due: 42.00 80101 12/28/2007 Drug Screen Non NIDA 5 Panel 1.00 4200 42.00 r Lisa G Crawford -Berry Balance Due: 42.00 80101 12/10/2007 Drug Screen Non NIDA 5 Panel 1.00 42.00 42.00 Andrea L Deis Balance Due: 42.00 80101 12/18/2007 Drug Screen Non NIDA 5 Panel 1 00 4200 42.00 l Amy N Doman Balance Due: 42.00 80101 12/10/2007 Drug Screen \Ton \TIDA 5 Panel 1 00 4200 42.00 Casey W Edwards Balance Due: 42.00 80101 12/20/2007 Drug Screen Non NIDA 5 Panel 1.00 4200 42.00 Deborah M Haire Balance Due: 42.00 80101 12/29/2007 Drug Screen Non NIDA 5 Panel 1 00 42.00 4200 Justin A Harrington Balance Due: 42.00 F Invoice 201295 (continued) page 2 Proc Code Service Date Description Quantity Charge Receipt Adjust Balance 80101 12/20/2007 Drug Screen Non NIDA 5 Panel 1.00 4200 4200 1 Alissa L Hinkle Balance Due: 42.00 80101 12/20/2007 Drug Screen Non NIDA 5 Panel 1 00 42.00 4200 Cara Kempf Balance Due: 42.00 80101 12/07/2007 Drug Screen Non NIDA 5 Panel 1.00 4200 4200 James L Lester Balance Due: 42.00 801-01 12/04/2007 Drug Screen Non NIDA 5 Panel 1.00 4200 4200 Kimberly R Matters Balance Due: 42.00 80101 12/07/2007 Drus Screen Non NIDA 5 Panel 1.00 42.00 4200 Terry D Myers Balance Due: 42.00 c- solol 12/03/2007 Drug Screen Non NIDA 5 Panel 1.00 4200 42.00 Kara Nefouse Balance Due: 42.00 t- t 80101 12/13/2007 Drug Screen Non NIDA 5 Panel 1 00 4200 4200 Lynn Owen Balance Due: 42.00 80101 12/12/2007 Drug Screen Non NIDA 5 Panel 1.00 42.00 42.00 Heather J Pastorius Balance Due: 42.00 y "30101 12/15/2007 Drug Screen Non NIDA 5 Panel 1 00 4200 42.00 Michael B Pinter Balance Due: 42.00 80101 12/11/2007 Drug Screen Non NIDA 5 Panel 1.00 42.00 4200 Cynthia R Scott Balance Due: 42.00 :J S0i01 12/20/2007 Drua Screen Non NIDA 5 Panel 1 00 4200 4200 Kaman K Sullivan Balance Due: 42.00 80101 12/22/2007 Drug Screen Non NIDA 5 Panel 1.00 42.00 42.00 Kelly L Wire Balance Due: 42.00 Invoice 201295 Balance Due: 840.00 i b Community Occupational Health Services P.O. Box 19383 Indianapolis, IN 46219 317- 355 -6335 Tax ID 35- 1955223 Invoice January 03, 2008 Bill to: Lynn Russell For: Carmel Clay Parks Recreation Carmel Clay Parks Recreation Dec 2007 1411 E. 116th St. Carmel, IN 46032- Invoice 201295 Proc Code Service Date Description Quantity Charge Receipt Adiusf Balance r PLEASE REMIT PAYMENT PROMPTLY S S r r Cut and return with payment 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 Description Date I Number I 'or note attached invoice's) or bill's)) I Amount 03- Jan -08 I 201295 (Employment drug testing (ESE) 12600 03- Jan -08 I 201295 I Employment drug testing (Monon Center) 63000 1/3/08 201295 (Employment drug testing (Adman) 8400 Total I 840.00 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 20_ Clerk- Treasurer I Voucher No Warrant No 355031 Community Occupational Health Services Allowed 20 PO Box 19383 Indianapolis, IN 46219 In Sum of 840.00 ON ACCOUNT OF APPROPRIATION FOR 101 104 Funds PO# or INVOICE NO ACCT #/TITLEI AMOUNT Board Members Dept 1046 I 201295 I 4340700 I 12600 1 hereby certify that the attached invoice(s), or 1047 I 201295 I 4340700 I 63000 bill(s) is (are) true and correct and that the 1125 I 201295 I 4340700 I 8400 materials or services itemized thereon for which charge is made were ordered and received except I I I I I I 17 -Jan 2008 i I SI ature 840.00 Business SerYI s Manager Cost distribution ledger classification if Title claim paid motor vehicle highway fund Community Occupational Health Services P.O. Box 19383 Indianapolis, IN 46219 317- 355 -6335 r Tax ID 35- 1955223 RC "i� V v=im I IAN 0 8 2008 Invoice December 04, 2007 BYJ/� Bill to: Lynn Russell For: Carmel Clay Parks Recreation Carmel Clay Parks Recreation Nov 2007 1411 E. 116th St. Carmel, IN 46032- �GvL1�/J Invoice 199068 Proc Code Service Date Description Quantity Charge Receipt Adjust Balance 80101 11/20/2007 Drug Screen Non NIDA 5 Panel 1 00 42.00 42.00 Donna Alves Balance Due: 42.00 10LIJ 80101 11/17/2007 Drug Screen Non NIDA 5 Panel 1.00 42.00 42.00 Kay C Asher Balance Due: 42.00 10(4 11/03/2007 Drug Screen Rapid 5 Panel 1.00 49.00 4900 Kimberlee A Bastian Balance Due: 80101 11/13/2007 Drug Screen Non NIDA 5 Panel 1.00 42.00 4200 Mary V Brookie Balance Due: PLO 42.00 80101 11/17/2007 Drug Screen Non NIDA 5 Panel 1 00 4200 4200 i- Jonathan A Clark Balance Due: IOL/7 42.00 c' 80101 11/21/2007 Drug Screen Non NIDA 5 Panel 1.00 4200 42.00 Kelly L Curry Balance Due: (syr' 42.00 Y 80101 11/07/2007 Drug Screen Non NIDA 5 Panel 1.00 42.00 42.00 Darla J Dunn Balance Due: 42.00 (016 80101 11/30/2007 Drug Screen Non NIDA 5 Panel 1 00 42.00 42.00 Kathleen J Faherty Balance Due: 42.00 o j �D Invoice 199068 (continued) page 2 Proc Code Service Date Description Quantity Charge Receipt Adjust Balance 80101 11/15/2007 Drug Screen Non NIDA 5 Panel 1.00 42.00 42.00 Stephanie L Fahl Balance Due: 1 42.00 80101 11/30/2007 Drug Screen Non NIDA 5 Panel 1.00 42.00 42.00 Leah J Frenzel Balance Due: 10Y6 42.00 80101 11/07/2007 Drug Screen Non NIDA 5 Panel 1.00 42.00 4200 Christine M Greene Balance Due: /C)C�7 42.00 80101 11/13/2007 Drug Screen Non NIDA 5 Panel 100 4200 42.00 Earnest K Hill Balance Due: I dC 42.00 n 80101 11/30/2007 Drug Screen Non NIDA 5 Panel 10 42.00 4200 F DeMarcus Q Johnson Balance Due: 42.00 80101 11/13/2007 Drug Screen Non NIDA 5 Panel 1 00 4200 42.00 Stephanie A Khan Balance Due: N/ 42.00 80101 11/27/2007 Drug Screen Non NIDA 5 Panel 1 00 42.00 42.00 Kyle R Killworth Balance Due: /Oy� 42.00 80101 11/30/2007 Drug Screen Non NIDA 5 Panel 1 00 4200 4200 Robert Klemen Balance Due: (OY7 42.00 80101 11/15/2007 Drug Screen Non NIDA 5 Panel 1.00 4200 4200 Adam T Leibold Balance Due: l oqf 42.00 80101 11;19/2007 Drug Screen Non NIDA 5 Panel 1 00 4200 4200 Sandra M Marchand Stenhof Balance Due:rO 3 42.00 80101 11, Drug Screen Non NIDA 5 Panel 1.00 42.00 4200 Sharon L McGoff Balance Due: 42.00 l 80101 11/14/2007 Drug Screen Non NIDA 5 Panel 1.00 4200 4200 Carol L Mettert Balance Due: �i 80101 11/28/2007 Drug Screen Non NIDA 5 Panel 1 00 4200 4200 Kataryna Mucklo Balance Due: 42.00 Invoice 199068 (continued) page 3 Proc Code Service Date Description Quantity Charge Receipt Adjust Balance 80101 11/15/2007 Drug Screen Non NIDA 5 Panel 1 00 42.00 42.00 Jennifer B Murphy Balance Due: 42.00 80101 11/26/2007 Drug Screen Non NIDA 5 Panel 1 00 4200 42.00 Dona M Robinson Balance Due:l� 42.00 80101 11/06/2007 Drug Screen Non NIDA 5 Panel 1.00 42.00 42.00 Emily M Satterthwaite Balance Due: 42.00 80101 11/16/2007 Drug Screen Non NIDA 5 Panel 1 00 42.00 4200 Ilya E Soyfer Balance Due: 1 42.00 80101 11/15/2007 Drug Screen Non NIDA 5 Panel 1.00 4200 42.00 I Jane E Sullivan Balance Due: 1 i 42.00 80101 11/20/2007 Drug Screen Non NIDA 5 Panel 1.00 4200 42.00 Dianne R Suveges Balance Due: p�� 42.00 80101 11/03/2007 Drug Screen Non NIDA 5 Panel 1.00 4200 4200 Catallina Theis Balance Due: (Qy� 42.00 80101 11/17/2007 Drug Screen Non NIDA 5 Panel 1.00 4200 4200 Joy D Turner Balance Due: r OC11 42.00 80101 11/30/2007 Drug Screen Non NIDA 5 Panel 100 42.00 4200 Rebecca S Weaver Balance Due: 42.00 80101 11/20/2007 Drug Screen Non NIDA 5 Panel 1.00 42.00 4200 Jennifer M Weber Balance Due: 42.00 80101 11/16/2007 Drug Screen Non NIDA 5 Panel 100 42.00 4200 Mary Weerts Balance Due: l•GW 42.00 Invoice 199068 Balance Due: 1351.00 1 J S Invoice 199068 (continued) page 4 Proc Code Service Date Description Quantity Charge Receipt Adjust Balance PLEASE REMIT PAYMENT PROMPTLY 1 /x V Z l3 yz 13- 1 F i t Cut and return with payment 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 Description Date I Number I (or note attached invoice(s) or bill(s)) Amount 04- Dec -07 I 199068 Employment drug testing (4 ESE, 28 Rec) 1,351 00 I I i Total 1,351.00 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 1 20 Clerk- Treasurer Voucher No Warrant No 355031 Community Occupational Health Services Allowed 20 PO Box 19383 Indianapolis, IN 46219 In Sum of 1,351.00 ON ACCOUNT OF APPROPRIATION FOR 104 Program Fund PO# or I INVOICE NO I ACCT #/TITLEI AMOUNT Board Members Dept 1046 I 199068 I. 4340700 I 16800 1 hereby certify that the attached invoice(s), or 1047 I 196912 I. 4340700 I 1,18300 bill(s) is (are) true and correct and that the materials or services itemized thereon for i which charge is made were ordered and received except I I I I I I 4 -Jan 2008 I I I I Signatde 1,351.00 Business Services Manager Cost distribution ledger classification if Title claim paid motor vehicle highway fund