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Home My WebLink About229264 2/12/2014 CITY OF CARMEL, INDIANA VENDOR: 367222 Page 1 of 1 ONE CIVIC SQUARE IU HEALTH WORKPLACE SERVICES LLC CH ECK AMOUNT: $35,485.01 2046 RELIABLE PKWY CARMEL, INDIANA 46032 CHICAGO IL 60686-0020 CHECK NUMBER: 229264 CHECK DATE: 2/12/2014 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 301 5023990 732804 4 , 374 . 16 OTHER EXPENSES 301 5023990 732845 27, 206 . 50 OTHER EXPENSES 1201 4358800 732860 60 . 00 TESTING FEES 301 5023990 732873 887 . 23 OTHER EXPENSES 301 5023990 732900 2 , 237 . 12 OTHER EXPENSES 1205 4347500 732949 720 . 00 GENERAL INSURANCE Indiana University Health Workplace Services, LLC 950 North Meridian Street Suite 200 3 Indianapolis, IN 46204 Phone: 317-963-1534 FEIN: 20-0994452 Invoice February 03, 2014 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Onsite Fees/Jan. 2014 1 Civic Square Cannel,IN 46032- Invoice# 732804 Proc Code Dale Description -QIY Charae Receipt Adjust Balance CARMBUIL 01/01/2014 City of Carmel Clinic Build Out 1.00 2574.16 2574.16 CARMLEAS 01/01/2014 City of Carmel Sports Performance 1.00 1800.00 1800.00 Lease Balance Due: 4374.16 Invoice# 732804 Balance Due: 4374.16 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK Submitted To FEB 10 2014 Clerk Treasurer 3 Cut and return with payment r Indiana University Health Workplace Services, LLC 950 North Meridian Street Suite 200'(City of Carmel) Indianapolis, IN 46204 Phone: 317-963-1534 FEIN: 20-0994452 Invoice February 03, 2014 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Misc.Onsite/Jan. 2014 1 Civic Square Carmel,IN 46032- Invoice# 732873 Proc Code Date Description Qty Charge Receipt Adjust Balance 99070 12/22/2013 Young at Heart Clinic Meds 1.00 369.68 369.68 99070 12/31/2013 Young at Heart Mail-Ins 1.00 65.38 65.38 99070 01/01/2014 Onsite Lab Charges 1.00 432.26 432.26 SBMF Labs for Dec.2013 99070 01/12/2014 Young at Heart Mail-Ins 1.00 19.91 19.91 Balance Due: 887.23 Invoice# 732873 Balance Due: 887.23 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK Submitted Fo FEB 102014 Clerk Treasurer Cut and return with payment Indiana University Health Workplace Services, LLC 950 North Meridian Street -30) Suite 200 (City of Carmel) Indianapolis, IN 46204 Phone: 317-963-1534 FEIN: 20-0994452 Invoice February 03, 2014 Bill to: Barbara Lamb For: City of Cannel-Onsite City of Cannel-Onsite Supply Billing/Jan. 2014 1 Civic Square Cannel,IN 46032- Invoice# 732900 Proc Code Date Description City Charge Receipt Adiust Balance 99070 01/01/2014 Onsite Operating Supplies 1.00 2237.12 2237.12 January 2014 Supplies Balance Due: 2237.12 Invoice# 732900 Balance Due: 2237,12 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK Submitted To FEB 10 2014 Clerk `treasurer Cut and return with payment Indiana University Health Workplace Services, LLC 950 North Meridian Street _3�1 Suite 200 (City of Carmel) Indianapolis, IN 46204 Phone: 317-963-1534 FEIN: 20-0994452 Invoice February 03, 2014 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel - Onsite Staff Time/Jan. 2014 1 Civic Square Cannel,IN 46032- Invoice# 732845 Proc Code Pete Description -Qty Charae Receipt Adjust Balance NURSEMA 01/02/2014 M.A.Nurse Time 4.00 112.00 112.00 Desire Riedy NURSEMD 01/02/2014 MD Staff Time 4.00 700.00 700.00 Dr.Fagan NURSENP 01/02/2014 N.P.Nurse Time 2.00 190.00 190.00 Erin McMurray NURSERN 01/02/2014 R.N.Nurse Time 4.00 248.00 248.00 Mareesa Martin NURSEMA 01/03/2014 M.A.Nurse Time 5.00 140.00 140.00 Cassandra Dean NURSEMD 01/03/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 01/03/2014 R.N.Nurse Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 01/07/2014 M.A.Nurse Time 4.00 112.00 112.00 Desire Riedy NURSEMD 01/07/2014 MD Staff Time 4.00 700.00 700.00 Dr.Fagan NURSERN 01/07/2014 R.N.Nurse Time 6.00 372.00 372.00 Mareesa Martin NURSEMA 01/08/2014 M.A.Nurse Time 5.00 140.00 140.00 Kimberly Pride NURSEMD 01/08/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 01/08/2014 R.N.Nurse Time 5.00 310.00 310.00 Natasha Cor NURSEMA 01/09/2014 M.A.Nurse Time 4.00 112.00 112.00 Kimberh,Pride NURSEMD 01/09/2014 MD Staff Time 4.00 700.00 700.00 Dr.Fagan NURSENP 01/09/2014 N.P.Nurse Time 2.00 190.00 190.00 Erin McMurray NURSERN 01/09/2014 R.N.Nurse Time 4.00 248.00 248.00 Mareesa Martin NURSEMA 01/10/2014 M.A.Nurse Time 5.00 140.00 140.00 Kimberly Pride NURSEMD 01/10/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan Invoice# 732845 (continued)page 2 NURSERN 01/10/2014 R.N.Nurse Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 01/13/2014 M.A.Nurse Time 5.00 140.00 140.00 Kimberly Pride NURSEMD 01/13/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSENP 01/13/2014 N.P.Nurse Time 2.00 190.00 190.00 Erin McMurrav NURSERN 01/13/2014 R.N.Nurse Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 01/14/2014 M.A.Nurse Time 6.00 168.00 168.00 Cassandra Dean NURSEMD 01/14/2014 MD Staff Time 6.00_ 1050.00 1050.00 Dr.Fagan NURSERN 01/14/2014 R.N.Nurse Time 6.00 372.00 372.00 Mareesa Martin NURSEMA 01/15/2014 M.A.Nurse Time 5.00 140.00 140.00 Kimberly Pride NURSEMD 01/15/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 01/15/2014 R.N.Nurse Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 01/16/2014 M.A.Nurse Time 4.00 112.00 112.00 Kimberly Pride NURSEMD 01/16/2014 MD Staff Time 4.00 700.00 700.00 Dr.Fagan NURSENP 01/16/2014 N.P.Nurse Time 2.50 237.50 237.50 Erin McMurrav NURSERN 01/16/2014 R.N.Nurse Time 4.00 248.00 248.00 Mareesa Martin NURSEMA 01/17/2014 M.A.Nurse Time 5.00 140.00 140.00 Kinnberly Pride NURSEMD 01/17/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 01/17/2014 R.N.Nurse Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 01/21/2014 M.A.Nurse Time 6.00 168.00 168.00 Angie Diuillio NURSEMD 01/21/2014 MD Staff Time 6.00 1050.00 1050.00 Dr.Fagan NURSERN 01/21/2014 R.N.Nurse Time 6.00 372.00 372.00 Mareesa Martin NURSEMA 01/22/2014 M.A.Nurse Time 5.00 140.00 140.00 Chen-1 Liggins NURSEMD 01/22/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 01/22/2014 R.N.Nurse Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 01/23/2014 M.A.Nurse Time 4.00 112.00 112.00 Cassandra Dean NURSEMD 01/23/2014 MD Staff Time 4.00 700.00 700.00 Dr.Joassin NURSENP 01/23/2014 N.P.Nurse Time 2.00 190.00 190.00 Erin McMurrav NURSERN 01/23/2014 R.N.Nurse Time 4.00 248.00 248.00 Mareesa Martin NURSEMA 01/24/2014 M.A.Nurse Time 5.00 140.00 140.00 Kimberly Pride Invoice# 732845 (continued)page 3 NURSEMD 01/24/2014 MD Staff Time 5.00 875.00 875.00 Dr.Antworth NURSERN 01/24/2014 R.N.Nurse Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 01/27/2014 M.A.Nurse Time 5.00 140.00 140.00 KimberlY Pride NURSEMD 01/27/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSENP 01/27/2014 N.P.Nurse Time 2.00 190.00 190.00 Erin McMurray NURSERN 01/27/2014 R.N.Nurse Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 01/28/2014 M.A.Nurse Time 6.00 168.00 168.00 Kimberlv Pride NURSEMD 01/28/2014 MD Staff Time 6.00 1050.00 1050.00 Dr.Fagan NURSERN 01/28/2014 R.N.Nurse Time 6.00 372.00 372.00 Mareesa Martin NURSEMA 01/29/2014 M.A.Nurse Time 5.00 140.00 140.00 Kimberlv Pride NURSEMD 01/29/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 01/29/2014 R.N.Nurse Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 01/30/2014 M.A.Nurse Time 4.00 112.00 112.00 Kimberlv Pride NURSEMD 01/30/2014 MD Staff Time 4.00 700.00 700.00 Dr.Fagan NURSENP 01/30/2014 N.P.Nurse Time 2.00 190.00 190.00 Erin McMurray NURSERN 01/30/2014 R.N.Nurse Time 4.00 248.00 248.00 Mareesa Martin NURSEMA 01/31/2014 M.A.Nurse Time 5.00 140.00 140.00 Kimberlv Pride NURSEMD 01/31/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 01/31/2014 R.N.Nurse Time 5.00 1310.00 310.00 eesa Martin Submitted To Balance Due: 27206.50 FEB 10 2014 Invoice# 732845 Balance Due: 27206.50 MAKE PAYME T TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE Clark Treasurer D TE-PLEASE INCLUDE INVOICE#ON CHECK ('ut and retnm with navmrnt Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER CityForm No.201(Rev.1995) 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 IU Health Workplace Services, LLC Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 09103114 732804 Onsote Fees/jan 2014 4,374.16 09103.114-- 732,973 nsite/jan 2014 887.23 02.103.114 7q9QQQ Billing/jen 2014 2,237. 12 02.103.114 732845 'Onsate Staff Time/ion 2014 27,206.50 Total $34,705.01 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 N002/10/14 WARRANT NO. ALLOWED 20 IU Health Workplace Services, LLC IN SUM OF $ 2046 Reliable Pkwy Chicago, IL 60686-0020 $ $34,705.01 ON ACCOUNT OF APPROPRIATION FOR 301 Medical Fund Board Members PO#or INVOICE NO. ACCT#/TITLE AMOUNT DEPT.# I hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and that the materials or services itemized thereon for 732804 301 $4,374.16 which charge is made were ordered and 732873 3 887.23 received except 732900 296.69 20 Signature Cost distribution ledger classification if Title claim paid motor vehicle highway fund Indiana University Health Workplace Services, LLC 950 North Meridian Street Suite 200 (City of Carmel) l �5 Indianapolis, IN 46204 Phone: 317-963-1534 FEIN: 20-0994452 Invoice February 03, 2014 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite EAP Services 1 Civic Square Carmel,IN 46032- Invoice# 732949 Proc Code Date Description QLY Charge Receipt Aayst Balance EAPSERV 01/01/2014 EAP Services 600.00 720.00 720.00 Balance Due: 720.00 Invoice# 732949 Balance Due: 720.00 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK Submitted To FEB 10 2014 Clerk Treasurer Cut and return with payment -------------------------------- ---- ----------- 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 i Date Number (or note attached invoice(s)or bill(s)) 02/03/14 732949 EAP Services $720.00 I hereby certify that the attached invoice(s), or bill(s), is(are)true and correct and I have audited same in accordance with IC 5-11-10-1.6 20 Clerk-Treasurer VOUCHER NO. WARRANT NO. ALLOWED 20 IU Health Workplace Services, LLC IN SUM OF$ 2046 Reliable Pkwy Chicago, IL 60686-0020 $720.00 ON ACCOUNT OF APPROPRIATION FOR Administration Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT - Board Members 1205 I 732949 I 43-475.00 I $720.00 I hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except Monda , February 10, 2014 r Director, Lministration Title Cost distribution ledger classification if claim paid motor vehicle highway fund Indiana University Health Workplace Services, LLC 950 North Meridian Street . Suite 200 (City of Carmel) )2�1 Indianapolis, IN 46204 Phone: 317-963-1534 FEIN: 20-0994452 Invoice February 03, 2014 Bill to: Barbara Lamb For: City of Carmel- Onsite_ City of Carmel-Onsite Onsite/Jan. 2014: I Civic Square Cannel,IN 46032- Invoice# 732860 Proc Code Date Description CSC Charoe Receipt„ q�just Balance 01/24/2014 Quick Read UDS/6panel includes . 15.00 Invoice# 732860 Balance Due: 60.00 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 0 DAY Of INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHEC m11tted To FEB 10 2014 Clerk Treasurer �$ Cut and return with payment Prescribed by State Board of Accounts Ci Form No.201 Rev.1 ry ( 995) i 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. i Payee Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s)or bill(s)) 02/03/14 732860 $60.00 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. ALLOWED 20 IU Health Workplace Services, LLC IN SUM OF $ 2046 Reliable Pkwy Chicago, IL 60686-0020 $60.00 ON ACCOUNT OF APPROPRIATION FOR Carmel HR Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1201 I 732860 I 43-588.00 I $60.00 1 hereby certify that the attached invoice(s), or 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 Monday, February 10, 2014 46- `J`-o— �yr Director, HR Title Cost distribution ledger classification if claim paid motor vehicle highway fund