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Home My WebLink About229998 03/12/14 01", CITY OF CARMEL, INDIANA VENDOR: 367222 ONE CIVIC SQUARE IU HEALTH WORKPLACE SERVICES LLCCHECK AMOUNT: S****36,574.32* CARMEL, INDIANA 46032 2046 RELIABLE PKWY CHECK NUMBER: 229998 CHICAGO IL 60686-0020 CHECK DATE: 03/12/14 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1201 4358800 732965 75.00 TESTING FEES 301 5023990 733000 27,477.50 OTHER EXPENSES 301 5023990 733001 4,374.16 OTHER EXPENSES 301 5023990 733110 1,865.02 OTHER EXPENSES 301 5023990 733128 2,062.64 OTHER EXPENSES 1205 4347500 733143 720.00 GENERAL INSURANCE Indiana University Health Workplace Services, LLC --- 950 North Meridian Street Suite 200 Indianapolis, IN 46204 Phone: 317-963-1534 FEIN: 20-0994452 Invoice March 03, 2014 Bill to: Barbara Lamb For: City of Carmel -Onsite City of Carmel -Onsite Onsite Fees/Feb. 2014 1 Civic Square Carmel, IN 46032- Invoice# 733001 Proc Code Date Descriptio 2y Charge Receiot Balance CARMBUIL 02/01/2014 City of Carmel Clinic Build Out 1.00 2574.16 2574.16 CARMLEAS 02/01/2014 City of Carmel Sports Performance 1.00 1800.00 1800.00 Lease Balance Due: 4374.16 Invoice# 733001 Balance Due: 4374.16 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE- PLEASE INCLUDE INVOICE#ON CHECK Submgtted To MAR 1 0 2014 Cier 4"re, asuir Cut and return with payment 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 March 03, 2014 Bill to: Barbara Lamb For: City of Carmel -Onsite City of Carmel -Onsite Misc.Onsite/Feb. 2014 1 Civic Square Carmel, IN 46032- - Invoice# 733128 Proc Code Date Description Doty Charge Receipt Adjust Balance 99070 01/19/2014 Young at Heart Clinic Meds 1.00 1033.84 1033.84 99070 01/19/2014 Young at Heart Mail-Ins 1.00 77.94 77.94 99070 02/01/2014 Onsite Lab Charges 1.00 950.86 950.86 January 20/4 SBA4F Labs Balance Due: 2062.64 Invoice# 733128 Balance Due: 2062.64 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE- PLEASE INCLUDE INVOICE#ON CHECK FMARSulb-hmitted To 10 2014 clerk Treasurer CutCu[and return with payment an hpa ------------------------------------------- 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 March 03, 2014 Bill to: Barbara Lamb For: City of Carmel -Onsite City of Carmel -Onsite Supply Billing/Feb. 2014 1 Civic Square Carmel, IN 46032- Invoice# 733110 Proc Code Date Descriotion gty Charge Receip Adjust Balance 99070 02/01/2014 Onsite Operating Supplies 1.00 1865.02 1865.02 February 2014 Supplies Balance Due: 1865.02 Invoice# 733110 Balance Due: 1865.02 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE- PLEASE INCLUDE INVOICE#ON CHECK Sub1mitted T® MAR 10 2014 Clerk Treasurer Cut and return with payment 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 March 03, 2014 Bill to: Barbara Lamb For: City of Carmel -Onsite City of Carmel -Onsite Staff Time/Feb.2014 1 Civic Square Carmel, IN 46032- _.____.--_. Invoice# 733000 Proc Code Dae Description Cly Charge Recei A&--FA Balance NURSEMA 02/03/2014 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride NURSEMD 02/03/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 02/03/2014 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 02/04/2014 M.A.Staff Time 6.00 168.00 168.00 Kimberly Pride NURSEMD 02/04/2014 MD Staff Time 6.00 1050.00 1050.00 Dr.Fagan NURSERN 02/04/2014 R.N.Staff Time 6.00 372.00 372.00 Mareesa Martin NURSEMA 02/05/2014 M.A.Staff-rime 5.00 140.00 140.00 Kimberly Pride NURSEMD 02/05/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 02/05/2014 R.N.Staff Time 5.00 310.00 310.00 Blair Fuller NURSEMA 02/06/2014 M.A.Staff Time 4.00 112.00 112.00 Kimberly Pride NURSEMD 02/06/2014 MD Staff Time 4.00 700.00 700.00 Dr.Fagan NURSENP 02/06/2014 N.P.Staff Time 2.00 190.00 190.00 Erin McMurray NURSERN 02/06/2014 R.N.Staff Time 4.00 248.00 248.00 Mareesa Martin NURSEMA 02/07/2014 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride NURSEMD 02/07/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 02/07/2014 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 02/10/2014 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride Submitted To NURSEMD 02/10/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSENP 02/10/2014 N.P.Staff Time 2.00 10 2014 190.00 Erin McMurray --------------- Invoice# 733000(continued)page 2 NURSERN 02/10/2014 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 02/11/2014 M.A.Staff Time 6.00 168.00 168.00 Kimberly Pride NURSEMD 02/11/2014 MD Staff Time 6.00 1050.00 1050.00 Dr.Fagan NURSERN 02/11/2014 R.N.Staff Time 6.00 372.00 372.00 Mareesa Martin NURSEMA 02/12/2014 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride NURSEMD 02/12/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 02/12/2014 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 02/13/2014 M.A.Staff Time 4,00 112.00 112.00 Kimberly Pride NURSEMD 02/13/2014 MD Staff Time 4.00 700.00 700.00 Dr.Fagan NURSENP 02/13/2014 N.P.Staff Time 2.00 190.00 190.00 Erin McMurray NURSERN 02/13/2014 R.N.Staff Time 4.00 248.00 248.00 Mareesa Martin NURSEMA 02/14/2014 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride NURSEMD 02/14/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 02/14/2014 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 02/17/2014 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride NURSEMD 02/17/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSENP 02/17/2014 N.P.Staff Time 2.00 190.00 190.00 Erin McMurray NURSERN 02/17/2014 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 02/18/2014 M.A.Staff Time 6.00 168.00 168.00 Kimberly Pride NURSEMD 02/J8/2014 MD Staff Time 6,00 1050.00 1050.00 Dr.Fagan NURSERN 02/18/2014 R.N.Staff Time 6.00 372.00 372.00 Mareesa Martin NURSEMA 02/19/2014 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride NURSEMD 02/19/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 02/19/2014 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 02/20/2014 M.A.Staff Time 4.00 112.00 112.00 Kimberly Pride NURSEMD 02/20/2014 MD Staff Time 4.00 700.00 700.00 Dr.Fagan NURSENP 02/20/2014 N.P.Staff Time 2.50 237.50 237.50 Erin McMurray NURSERN 02/20/2014 R.N.Staff Time 4.00 248.00 248.00 Mareesa Martin NURSEMA 02/21/2014 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride Invoice# 733000(continued)page 3 NURSENP 02/21/2014 N.P.Staff Time 5.00 475.00 475.00 Randi Antworth NURSERN 02/21/2014 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 02/24/2014 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride NURSEMD 02/24/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSENP 02/24/2014 N.P.Staff Time 2.00 190.00 190.00 Erin McMurray NURSERN 02/24/2014 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 02/25/2014 M.A.Staff Time 6.00 168.00 168.00 Kimberly Pride NURSEMD 02/25/2014 MD Staff Time 6.00 1050.00 1050.00 Dr.Fagan NURSERN 02/25/2014 R.N.Staff Time 6.00 372.00 372.00 Mareesa Martin NURSEMA 02/26/2014 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride NURSEMD 02/26/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 02/26/2014 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 02/27/2014 M.A.Staff Time 4.00 112.00 112.00 Kimberly Pride NURSEMD 02/27/2014 MD StaffTime 4.00 700.00 700.00 Dr.Fagan NURSENP 02/27/2014 N.P.Staff Time 2.00 190.00 190.00 Erin McMurray NURSERN 02/27/2014 R.N.Staff Time 4.00 248.00 248.00 Mareesa Martin NURSEMA 02/28/2014 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride NURSEMD 02/28/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 02/28/2014 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin Balance Due: 27477.50 Invoice# 733000 Balance Due: 27477.50 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE- PLEASE INCLUDE INVOICE#ON CHECK Cut and return with payment - -------- --- Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form 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)) 4,374.16 03/03/14 73300 1 E)nsite Fees/ Feb 2014 2,062.64 0 1,865.02 037G3TT4—t331 1 u supply Billing/ Feb 2014. 27,477.50 03/0 Onsite Staff Time! Feb 2014 35,779. 2 Total 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 20Clerk-Treasurer VOUCHER r4QIQn4 WARRANT NO. ALLOWED 20 IU Health Workplace Services, LLC IN SUM OF $ 2046 Reliable Pkwy Chicago, IL 60686-0020 $$35,779.32 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 733001 301 $ ,374.16 which charge is made were ordered and 733128 301 $2,062.64 received except 71111 n 201 n 20 c2' Signature Cost distribution ledger classification if Title claim paid motor vehicle highway fund Indiana University Health Workplace Services, LLC 12c�1 950 North Meridian Street Suite 200 (City of Carmel) Indianapolis, IN 46204 Phone: 317-963-1534 FEIN: 20-0994452 Invoice March 03, 2014 Bill to: Barbara Lamb For: City of Carmel -Onsite City of Carmel -Onsite Onsite/Feb.2014 1 Civic Square Carmel, IN 46032- ._..._________ _ --Invoice# 732965 Proc Code Date Description 15.00 MAR 10 2014 Invoice# 732965 Balance Due: 5.00 Cierk Tre"bV&YM NT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE ATE- PLEASE INCLUDE INVOICE#ON CHECK Cut and return- eturn with payment - -------- --- -- VOUCHER NO. WARRANT NO. ALLOWED 20 IU Health Workplace Services, LLC IN SUM OF $ 2046 Reliable Pkwy Chicago, IL 60686-0020 $75.00 ON ACCOUNT OF APPROPRIATION FOR Carmel HR Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1201 I 732965 I 43-588.00 I $75.00 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, March 10, 2014 Director, HR Title Costdistribution ledger classification if claim paid motor vehicle highway fund 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)) 03/03/14 732965 $75.00 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 Indiana University Health Workplace Services, LLC 950 North Meridian Street Suite 200 (City of Carmel) Indianapolis, IN 46204 �2"s Phone: 317-963-1534 FEIN: 20-0994452 Invoice March 03, 2014 Bill to: Barbara Lamb For: City of Cannel -Onsite City of Carmel -Onsite EAP Services/Feb. 2014 1 Civic Square Carmel, IN 46032- Invoice# 733143�� Proc Code Date Description —Qty Charge Receipt A 'ust Balance EAPSERV 02/01/2014 EAP Services 600.00 720.00 720.00 Balance Due: 720.00 Invoice# 733143 Balance Due: 720.00 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE- PLEASE INCLUDE INVOICE#ON CHECK Su.ubmitted. To MAR 10 2014 Clerk Treasurer n b` Cut and retum with payment �aa€s�=�.asa—'•mss -------------------------------------------------.. 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 i Administration Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT BOardMembeiS 1205 I 733143 I 43-475.00 I I I hereby certify that the attached invoice(s), or $720.00 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 Monday arch 10, 2014 r Director, Administration Title Cost distribution ledger classification if claim paid motor vehicle highway fund 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)orbill(s)) 03/03/14 733143 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