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Home My WebLink About222887 08/13/2013 CITY OF CARMEL, INDIANA VENDOR: 355031 Page 1 of 1 ONE CIVIC SQUARE COMMUNITY OCCUPATIONAL HEALTH SgEER CARMEL, INDIANA 46032 7169 SOLUTION CENTER MK AMOUNT: $94.00 CHICAGO IL 60677-7001 CHECK NUMBER: 222887 CHECK DATE: 8/1312013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1082 4340700 356029 47 . 00 MEDICAL FEES 1081 4340700 356888 47 . 00 MEDICAL FEES Community Occupational Health Svs 7169 Solution Center Chicago, IL 60677-7001 Phone: 317-621-0341 FEIN: 35-1955223 ' I JUL 18 2013 Invoice July 16, 2013 Bill to: Lynn Russell For: Cannel Clay Parks & Recreation Cannel Clay Parks & Recreation 1411 E. 1 16th St. Cannel, IN 46032- Invoice# 356029 Proc Code Date Description QtV Charge Receipt Adiust Balance 746404 07/01/2013 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Alexia L Ohnemus Balance Due: 47.00 Invoice# 356029 Balance Due: 47.00 PLEASE REMIT PAYMENT PROMPTLY Purchase n s l XV g T ds P.O.- PorF i_in uTi bescr r _ _ 9te_��Z Z ( � Cut and return with payment Community Occupational Health Svs 7169 Solution Center Chicago, IL 60677-7001 Phone: 317-621-0341 FEIN: 35-1955223 JUL 18 2013 Invoice July 16, 2013 Bill to: Lynn Russell For: Cannel Clay Parks & Recreation Cannel Clay Parks & Recreation 7/13 1411 E. 116th St. Cannel, IN 46032- Invoice # 356888 Proc Code Date Description Qty Charge Recei t Adjust Balance 746404 07/10/2013 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 S Blake T Adams Balance Due: 47.00 Invoice# 356888 Balance Due: 47.00 PLEASE REMIT PAYMENT PROMPTLY Purchase Description Alt- P.O. � # PorF G.L.# 10 l- 9 --q.3 V0 1 O U — Budget '1� e S l pN s TWA) QA) Descr_ Q P,;rchaser to ate ] ZZ 113 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 7169 Solution Center Chicago, IL 60677-7001 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO# Amount 7/16/13 356029 Pre-employment drug testing $ 47.00 7/16/13 356888 Pre-employment drug testing $ 47.00 Total $ 94.00 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 7169 Solution Center Chicago, IL 60677-7001 In Sum of$ $ 94.00 ON ACCOUNT OF APPROPRIATION FOR 108 ESE PO#or Board Members INVOICE NO. ACCT#/TITLE AMOUNT Dept# 1082-99 356029 4340700 $ 47.00 1 hereby certify that the attached invoice(s), or 1081-99 356888 4340700 $ 47.00 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 8-Aug 2013 $ 94.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund