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Home My WebLink About221003 06/18/2013 i CITY OF CARMEL, INDIANA VENDOR: 355031 Page 1 of 1 ONE CIVIC SQUARE COMMUNITY OCCUPATIONAL HEALTH CHE�K AMOUNT: $940.00 CARMEL, INDIANA 46032 7169 SOLUTION CENTER CHICAGO IL 60677-7001 CHECK NUMBER: 221003 CHECK DATE: 6/18/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1081 4340700 350851 188 . 00 MEDICAL FEES 1082 4340700 350851 705 . 00 MEDICAL FEES 1091 4340700 350851 47 . 00 MEDICAL FEES I Community Occupational Health Svs Purchase 7169 Solution Center Description - z Chicago, IL 60677-7001 P.O.# P or F Phone: 317-621-0337 FEIN: 35-1955223 `T-f 7--r" i�e'escr C�J S 7MAY 21 2013 i Purchaser at Approval Date Invoice I q/= y3 V07 0 0 - Y7. 00 !0 1?1- 9 ? Y3Y0700 -- 4 !X8. 00 May 16, 2013 /0&a- 49- Y3Y0700 - ff 00 Bill to: Lynn Russell For: Cannel Clay Parks & Recreation Carmel Clay Parks & Recreation 5-13 1411 E. 1 16th St. Cannel, IN 46032- Invoice # 350851 Proc Code Date Description Qty_ Charge Receipt Adlust Balance 746404 05/06/2013 Drug Scrccn-Non NIDA 5 Panel 1.00 47.00 47.00 Lauren J Bangs Balance Due: C 47.00 746404 05/08/2013 Drug Screen- Non NIDA 5 Panel 1.00 47.00 47.00 Sydney A Bartel Balance Due: 47.00 746404 05/09/2013 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 George B Botros Balance Due: 47.00 746404 05/10/2013 Drug Screen -Non NIDA 5 Panel 1.00 47.00 47.00 Margaret C Duxbury Balance Due: s 47.00 746404 05/12/2013 Drug Screcn-Non NIDA 5 Panel 1.00 47.00 47.00 lulia S Goins Balance Due: r 47.00 746404 05/11/2013 Drug Screen-Non NIDA 5 Pancl 1.00 47.00 47.00 Benjamin N Hatfield Balance Due: 47.00 746404 05/10/2013 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Jennifer K Hunt Balance Due: S 47.00 746404 05/09/2013 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Stephanie M Lukas Balance Due: 47.00 746404 05/09/2013 Drug Screen-Non N I DA 5 Panel 1.00 47.00 47.00 Caroline G Marshall Balance Due: C 47.00 746404 05/10/2013 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Hanna McBride Balance Due: 47.00 746404 05/09/2013 Drug Screen-Non NIDA 5 Pancl 1.00 47.00 47.00 Lauren M McRoberts Balance Due: V 47.00 746404 05/07/2013 Drug Screen- Non NIDA 5 Panel 1.00 47.00 47.00 Invoice # 350851 (continued) page 2 Matthew L Nicisenhelder Balance Due: C- 47.00 746404 05/07/2013 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Amanda Monaghan Balance Due: (� 47.00 746404 05/12/2013 Drug Screen-Non NIDA 5 Panel 1.00 47.00 v 47.00 Grace Pickering Balance Due: 47.00 746404 05/05/2013 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Andrew J Riley Balance Due: 47.00 746404 05/08/2013 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Sydney Smith Balance Due: G 47.00 746404 05/09/2013 Drug Screen-Non NIDA 5 Pancl 1.00 47.00 47.00 Katie M Tourney Balance Due: 47.00 746404 05/09/2013 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Kristen H Trimpe Balance Due: C 47.00 746404 05/08/2013 Drug Screen- Non NIDA 5 Panel 1.00 47.00 47.00 Annesia R Wright Balance Due: S 47.00 746404 05/03/2013 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Stacey Zimmerman Balance Due: 47.00 Invoice# 350851 Balance Due: 940.00 PLEASE REMIT PAYMENT PROMPTLY Cut and return with payment Li ACCOUNTS PAYABLE VOUCHER i 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. PayeIe I Purchase Order No. 355031 Community Occupational Health Services Terms 7169 Solution Center Chicago, IL 60677-7001 i rl Invoice ` Invoice Description Date 'Number (or note attached invoice(s) or bill(s)) PO # Amount 5/16/13 350851 Pre-employment drug testing $ 47 00 5/16/13 350851 Pre-employment drug testing $ 188.00 5/16/13 350851 Pre-employment drug testing $ 705.00 r� ii 'I Total $ 940.00 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 Voucher No. Warrant No. 355031 Community Occupational Health Services Allowed 20 7169 Solution Center Chicago, IL 60677-7001 In Sum of$ $ 940.00 ON ACCOUNT OF APPROPRIATION FOR 108 ESE/ 109 MCC PO#or Board Members INVOICE NO. ACCT#/TITL AMOUNT Dept# 1091 350851 4340700 $ 47.00 1 hereby certify that the attached invoice(s), or 1081-99 350851 4340700 $ 188.00 bill(s) is (are)true and correct and that the 1082-99 350851 4340700 $ 705.00 materials or services itemized thereon for which charge is made were ordered and received except 13-Jun 2013 Signature $ 940.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund