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Home My WebLink About227976 1 /14/2014 CITY OF CARMEL, INDIANA VENDOR: 355031 Page 1 of 1 ONE CIVIC SQUARE COMMUNITY OCCUPATIONAL HEALTH MK AMOUNT: $188.00 CARMEL, INDIANA 46032 7169 SOLUTION CENTER ti_o gip, CHICAGO IL 60677-7001 CHECK NUMBER: 227976 CHECK DATE: 1/14/2014 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1081 4340700 369177 141 . 00 MEDICAL FEES 1081 4340700 370760 47 . 00 MEDICAL FEES Community Occupational Health Svs 7169 Solution Center Chicago, IL 60677-7001 cam; ?; `'ice''' 7 +; Phone: 317-621-0341 FEIN: 35-1955223 DEC 9 2913 `x Invoice December 16, 2013 Bill to: Lynn Russell For: Cannel Clay Parks & Recreation Cannel Clay Parks & Recreation 12/13 1411 E. 116th St. Cannel, IN 46032- Invoice# 370760 Proc Code Date Description Qty Charge Receipt Adiust Balance 746404 12/13/2013 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Mary J Milligan Balance Due: 47.00 Invoice# 370760 Balance Due: 47.00 PLEASE REMIT PAYMENT PROMPTLY P,,rchase V I }SCS IJVtI' ��v`S� Cs cr0t on 0- 'V, ( y P.O.# PorF G-.L.# l 0 8�— — -� y o 00 Linc Descr Purchaser ate AP roval _Date 5- 19 1 13 Cut and retum with payment Community Occupational Health Svs 7169 Solution Center Chicago, IL 60677-7001 Phone: 317-621-0341 FDEEC FEIN: 35-1955223 3 0 2013 . Invoice December 03, 2013 Bill to: Lynn Russell For: Carmel.Clay Parks & Recreation Carmel Clay Parks & Recreation 11/13 1411 E. 116th St. Carmel, IN 46032- __ Invoice# 369177 Proc Code Date Description Q_yt Charge Receipt Adjust Balance 746404 11/22/2013 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Mina M Farahan Balance Due: 47.00 746404 11/21/2013 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Sarah J Lucas Balance Due: 47.00 746404 11/21/2013 Drug Screen-Non NIDA 5 Panel 1.00 47.00 47.00 Chelsea Pineda Balance Due: 47.00 Invoice# 369177 Balance Due: ✓ 141.00 PLEASE REMIT PAYMENT PROMPTLY P„rebase DC'scription P.O.# � v� - PorF c.L.# IOU- 9 y3 � C) 700 Budget I_ine'Descr Purchaser Date Approval Dc ie 7 OrCut and return with payment -------------------------------------------------------------------------- -- Please remit 141.00 to Community Occupational Health Services 7169 Solution Center Please place invoice number 369177 on check Chicago,IL 60677-7001 Phone: 317-621-0341 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 12/16/13 370760 Pre-employment drug testing $ 47.00 12/3/1.3. 369177 Pre-employment drug testing $ 141.00 Total $ 188.00 I hereby certify that the attached invoice(s), or bill(s)is(are)true and correct and I have audited same in accordance r 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$ $ 188.00 ON ACCOUNT OF APPROPRIATION FOR f 108 ESE PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members Dept# 1081-99 370760 4340700 $ 47.00 1 hereby certify that the attached invoice(s), or 1081-99 369177 4340700 $ 141.00 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 9-Jan 2014 $ 188.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund