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HomeMy WebLinkAbout222049 07/17/2013 CITY OF CARMEL, INDIANA VENDOR: 367222 Page 1 of 1 ONE CIVIC SQUARE IU HEALTH WORKPLACE SERVICES LL&ECK AMOUNT: $666.00 CARMEL, INDIANA 46032 2046 RELIABLE PKWY CHICAGO IL 60686-0020 CHECK NUMBER: 222049 CHECK DATE: 7/17/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1201 4358800 728697 75 . 00 TESTING FEES 1201 4358800 728698 531 . 00 TESTING FEES 1201 4358800 729545 60 . 00 TESTING FEES I ! I Indiana University Health Workplace Services, LLC 4850 W. Century Plaza Rd. WP-City of Carmel ' Indianapolis, IN 46254-5477 317-216-2828 Tax ID# 20-0994452 Invoice July 1, 2013 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Onsite/May 2013 1 Civic Square Carmel,IN 46032- Invoice# 728698 Proc Code Service Date Description Quanti Charae Rereip Adiust Balance 05/02/2013 Quick Read UDS/6panel includes 15.00 kit D Q � JUL 15 2013 By Invoice# 728698(continued)page 2 Proc Code ! Service Date Description Quanti Charge Receipt Adjust Balance 15.00 kit Invoice# 728698 (continued)page 3 Proc Code Service Date Description 15.00 Invoice# 728698 (continued)page 4 Proc Code Service Date Descdptio Quantit Charge Re i Adiust Balance 82075 05/10/2013 Evidential Breath-Reg. 531.00 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK I i Cut and return with payment Indiana University Health Workplace Services, LLC 4850 W. Century Plaza Rd. WP-City of Carmel Indianapolis, IN 46254-5477 317-216-2828 Tax ID# 20-0994452 Invoice July 1, 2013 Bill to: Barbara Lamb For: City of Carmel -Onsite City of Carmel -Onsite Onsite/April 2013 1 Civic Square Carmel, IN 46032- Invoice# 729545 � y �~ Proc Code Service Date Description Quantit Charge Receipt Adjust Balance 04/25/2013 Quick Read UDS/6panel includes 60.00 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE- PLEASE INCLUDE INVOICE#ON CHECK D JUL 15 2013 By Cut and return with payment 1 Indiana University Health Workplace Services, LLC �-- 4850 W. Century Plaza Rd. WP-City of Carmel Indianapolis, IN 46254-5477 317-216-2828 Tax ID# 20-0994452 Invoice July 1, 2013 Bill to: Barbara Lamb For: City of Carmel -Onsite City of Carmel -Onsite Onsite/June 2013 1 Civic Square Carmel, IN 46032- __ --------- ----- -'. Invoice# 728697 Proc Code Service Date Description Quanti t Charge Receipt Adiust Balance 06/03/2013 Quick Read UDS/6panel includes 1.00 15.00 15.00 kit 75.00 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE- PLEASE INCLUDE INVOICE#ON CHECK A Cut and return with o. Prescribed by State Board of Accounts City Form No.201 (Rev. 1995) ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice or 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. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 07/01/13 728697 $75.00 07/01/13 729545 $60.00 07/01/13 I 728698 I I $531.00 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. ALLOWED 20 IU Health Workplace Services, LLC IN SUM OF $ 2046 Reliable Pkwy Chicago, IL 60686-0020 $666.00 ON ACCOUNT OF APPROPRIATION FOR Carmel HR Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1201 728697 43-588.00 $75.00 I hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and that the 1201 729545 43-588.00 $60.00 materials or services itemized thereon for 1201 I 728698 I 43-588.00 I $531.00 which charge is made were ordered and received except Thursday, July 11, 2013 Director, HR Title Cost distribution ledger classification if claim paid motor vehicle highway fund