HomeMy WebLinkAbout232254 05/07/14 ai CITY OF CARMEL, INDIANA VENDOR: 367222
® ONE CIVIC SQUARE IU HEALTH WORKPLACE SERVICES LLCCHECK AMOUNT: $*"**45,805.62*
r. _� CARMEL, INDIANA 46032 2046 RELIABLE PKWY CHECK NUMBER: 232254
'+i,,�oN�� CHICAGO IL 60686-0020 CHECK DATE: 05/07/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1201 4358800 733407 165.00 TESTING FEES
301 5023990 733439 10,613.85 OTHER EXPENSES
301 5023990 733500 28,852.50 OTHER EXPENSES
301 5023990 733501 4,374.16 OTHER EXPENSES
1205 4347500 733558 720.00 GENERAL INSURANCE
301 5023990 733673 1,080.11 OTHER EXPENSES
Indiana University Health Workplace Services,LLC
950 North Meridian Street
Suite 200
/] {� Indianapolis, IN 46204
` (•J' Phone: 317-963-1534
FEIN: 20-0994452
Invoice
May 01, 2014
Bill to: Barbara Lamb For: City of Carmel-Onsite
City of Carmel-Onsite' Onsite Fees/April 2014
1 Civic.Square
Carmel,IN 46032-
Invoice# 733501
Proc Code pate Description Qty Charge Receil2 Adjust Balance
CARMBUIL 04/01/2014 City of Carmel Clinic Build Out 1.00 2574.16 2574.16
CARMLEAS 04/01/2014 City of Cannel Sports Performance 1.00 1800.00 1800.00
Lease
Balance Due: 4374.16
Invoice# 733501 Balance Due: 4374.16
MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE
DATE-PLEASE INCLUDE INVOICE#ON CHECK
Subinitted
_MAY 0 5 2014
Clark Treasurer]
y Cut and return with payment
rr� 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
May 01, 2014
Bill to: Barbara Lamb For: City of Carmel-Onsite
City of Carmel-Onsite Misc.Onsite/Apri12014
1 Civic Square
Carmel,IN 46032-
Invoice# 733439
Proc Code Date Description (may Charae Receipt just Balance
99070 03/09/2014 Young at Heart Clinic Meds 1.00. 765.11 765.11
99070 03/23/2014 Young at Heart Clinic Meds 1.00 607.51 607.51
99070 03/31/2014 Young at Heart Clinic Meds 1.00 1570.52 1570.52
99070 04/01/2014 Onsite Lab Charges 1.00 1635.60 1635.60
SBMF Labs for March 2014
99070 04/13/2014 Young at Heart Mail-Ins 1.00 5366.38 5366.38
99070 04/20/2014 Young at Heart Mail-Ins 1.00 668.73 668.73
Balance Due: 10613.85
Invoice# 733439 Balance Due: 10613.85
MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE
DATE-PLEASE INCLUDE INVOICE#ON CHECK
Submitted To
MAY 0 5 2014
Clerk Treasurer
Cut and return with payment
Indiana University Health Workplace Services, LLC
A 950 North Meridian Street
Suite 200 (City of Carmel)
C Indianapolis, IN 46204
Phone: 317-963-1534
FEIN: 20-0994452
Invoice
May 01, 2014
Bill to: Barbara Lamb For: City of Carmel-Onsite
City of Carmel-Onsite Supply Billing/April 2014
1 Civic Square
Carmel,IN 46032-
Invoice# 733673
Proc Code Date Descri tion Dw Charae Receipt AAdoust Balance
99070 04/01/2014 Onsite Operating Supplies 1.00 1080.11 1080.11
Aprf12014 Supplies
Balance Due: 1080.11
Invoice# 733673 Balance Due: 1080.11
MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE
DATE-PLEASE INCLUDE INVOICE#ON CHECK
F7Subrnitted To
MAY 052014
Clark Treasvirer
i1 �, 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
May 01, 2014
Bill to: Barbara Lamb For: City of Carmel-Onsite
City of Carmel-Onsite Staff Time/April 2014
1 Civic Square
Carmel,IN 46032-
Invoice# 733500
Proc Code Date Description -Q1C Charge Receipt Adiust Balance
NURSENP 03/31/2014 N.P.Staff Time 2.50 237.50 237.50
Erin McMurray
NURSEMA 04/01/2014 M.A.Staff Time 6.00 168.00 168.00
Kimberly Pride
NURSEMD 04/01/2014 MD Staff Time 6.00 1050.00 1050.00
Dr.Kane
NURSERN 04/01/2014 R.N.Staff Time 6.00 372.00 372.00
Mareesa Martin
NURSEMA 04/02/2014 M.A.Staff Time 5.00 140.00 140.00
Kimberly Pride
NURSENP 04/02/2014 N.P.Staff Time 5.00 475.00 475.00
Randi Antworth
NURSERN 04/02/2014 R.N.Staff Time 5.00 310.00 310.00
Mareesa Martin
NURSEMA 04/03/2014 M.A.Staff Time 4.00 112.00 112.00
Kimberly Pride
NURSEMD 04/03/2014 MD Staff Time 4.00 700.00 700.00
Dr.Kane
NURSERN 04/03/2014 R.N.Staff Time 4.00 248.00 248.00
Mareesa Martin
NURSEMA 04/04/2014 M.A.Staff Time 5.00 140.00 140.00
Kimberly Pride
NURSENP 04/04/2014 N.P.Staff Time 5.00 475.00 475.00
Randi Antworth
NURSERN 04/04/2014 R.N.Staff Time 5.00 310.00 310.00
Mareesa Martin
NURSEMA 04/07/2014 M.A.Staff Time 5.00 140.00 140.00
Kimberly Pride
NURSEMD 04/07/2014 MD Staff Time 5.00 875.00 875.00
Dr.Fagan
NURSERN 04/07/2014 R.N.Staff Time 5.00 310.00 310.00
Mareesa Martin
NURSEMA 04/08/2014 M.A.Staff Time 6.00 168.00 168.00
Kimberly Pride
NURSEMD 04/08/2014 MD Staff Time 6.00 1050.00 1050.00
Dr.Fagan
NURSERN 04/08/2014 R.N.Staff Time 6.00 372.00 372.00
Mareesa Martin
Invoice# 733500(continued)page 2
NURSEMA 04/09/2014 M.A.Staff Time 5.00 140.00 140.00
Kimberly Pride
NURSEMD 04/09/2014 MD Staff Time 5.00 875.00 875.00
Dr.Fagan
NURSERN 04/09/2014 R.N.Staff Time 5.00 310.00 310.00
Mareesa Martin
NURSEMA 04/10/2014 M.A.Staff Time 4.00 112.00 112.00
Kimberly Pride
NURSEMD 04/10/2014 MD Staff Time 4.00 700.00 700.00
Dr.Fagan
NURSERN 04/10/2014 R.N.Staff Time 4.00 248.00 248.00
Mareesa Martin
NURSEMA 04/11/2014 M.A.Staff Time 5.00 140.00 140.00
Kimberly Pride
NURSEMD 04/11/2014 MD Staff Time 5.00 875.00 875.00
Dr.Fagan
NURSERN 04/11/2014 R.N.Staff Time 5.00 310.00 310.00
Mareesa Martin
NURSEMA 04/14/2014 M.A.Staff Time 5.00 140.00 140.00
Kimberly Pride
NURSEMD 04/14/2014 MD Staff Time 5.00 875.00 875.00
Dr.Fagan
NURSERN 04/14/2014 R.N.Staff Time 5.00 310.00 310.00
Mareesa Martin
NURSEMA 04/15/2014 M.A.Staff Time 6.00 168.00 168.00
Kimberly Pride
NURSEMD 04/15/2014 MD Staff Time 6.00 1050.00 1050.00
Dr.Fagan
NURSERN 04/15/2014 R.N.Staff Time 6.00 372.00 372.00
Mareesa Martin
NURSEMA 04/16/2014 M.A.Staff Time 5.00 140.00 140.00
Kimberly Pride
NURSEMD 04/16/2014 MD Staff Time 5.00 875.00 875.00
Dr.Fagan
NURSERN 04/16/2014 R.N.Staff Time 5.00 310.00 310.00
Mareesa Martin
NURSEMA 04/17/2014 M.A.Staff Time 4.00 112.00 112.00
Kimberly Pride
NURSEMD 04/17/2014 MD Staff Time 4.00 700.00 700.00
Dr.Fagan
NURSERN 04/17/2014 R.N.Staff Time 4.00 248.00 248.00
Mareesa Martin
NURSEMA 04/18/2014 M.A.Staff Time 5.00 140.00 140.00
Kimberly Pride
NURSEMD 04/18/2014 MD Staff Time 5.00 875.00 875.00
Dr.Fagan
NURSERN 04/18/2014 R.N.Staff Time 5.00 310.00 310.00
Mareesa Martin
NURSEMA 04/21/2014 M.A.Staff Time 5.00 140.00 140.00
Kimberly Pride
NURSEMD 04/21/2014 MD Staff Time 5.00 875.00 875.00
Dr.Fagan
NURSERN 04/21/2014 R.N.Staff Time 5.00 310.00 310.00
Mareesa Martin
NURSEMA 04/22/2014 M.A.Staff Time 6.00 168.00 168.00
Kimberly Pride
NURSEMD 04/22/2014 MD Staff Time 6.00 1050.00 1050.00
Dr.Fagan
Invoice# 733500(continued)page 3
NURSERN 04/22/2014 R.N.Staff Time 6.00 372.00 372.00
Mareesa Martin
NURSEMA 04/23/2014 M.A.Staff Time 5.00 140.00 140.00
Kimberly Pride
NURSEMD 04/23/2014 MD Staff Time 5.00 875.00 875.00
Dr.Fagan
NURSERN 04/23/2014 R.N.Staff Time 5.00 310.00 310.00
Mareesa Martin
NURSEMA 04/24/2014 M.A.Staff Time 4.00 112.00 112.00
Kimberly Pride
NURSEMD 04/24/2014 MD Staff Time 4.00 700.00 700.00
Dr.Fagan
NURSERN 04/24/2014 R.N.Staff Time 4.00 248.00 248.00
Mareesa Martin
NURSEMA 04/25/2014 M.A.Staff Time 5.00 140.00 140.00
Kimberly Pride
NURSEMD 04/25/2014 MD Staff Time 5.00 875.00 875.00
Dr.Arnett
NURSERN 04/25/2014 R.N.Staff Time 5.00 310.00 310.00
Mareesa Martin
NURSEMA 04/28/2014 M.A.Staff Time 5.00 140.00 140.00
Kimberly Pride
NURSEMD 04/28/2014 MD Staff Time 5.00 875.00 875.00
Dr.Fagan
NURSERN 04/28/2014 R.N.Staff Time 5.00 310.00 310.00
Mareesa Martin
NURSEMA 04/29/2014 M.A.Staff Time 6.00 168.00 168.00
Kimberly Pride
NURSEMD 04/29/2014 MD Staff Time 6.00 1050.00 1050.00
Dr.Fagan
NURSERN 04/29/2014 R.N.Staff Time 6.00 372.00 372.00
Mareesa Martin
NURSEMA 04/30/2014 M.A.Staff Time 5.00 140.00 140.00
Kimberly Pride
NURSEMD 04/30/2014 MD Staff Time 5.00 875.00 875.00
D agan
NURSERN 04/30/2014 R. .Staff Ti b fitted To 5.00 310.00 310.00
M eesa Martin
MAY ® 5 2014 Balance Due: 28852.50
Invoice# 733500 Balance Due: 28852.50
MAKE PAYME bHIN 30 DAYS OF INVOICE
DATE-PLEASE INCLUDE INVOICE#ON CHECK
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
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))
11A 41374.16
MOV14 7330V 1 Onsite Fees/April 2014
05/0!tt*--- 733439 Mise E)risite/APO 2014. 10,613.85
06101/14 733673 Supply Billing!ApFil 2014 1.080-11
0510 1f14 733500 Onsite Staff Time/ApFil 2014 9RAR9 50
I
Total 44,920.62---
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 Ng4—_WARRANT NO.
ALLOWED 20
IU Health Workplace Services, LLC IN SUM OF $
2046 Reliable Pkwy
Chicago, IL 60686-0020
$ 44,920.62
ON ACCOUNT OF APPROPRIATION FOR
301 Medical Fund
Board Members
Po#or INVOICE NO. ACCT#/TITLE AMOUNT
DEPT.# 1 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
733501 n n 1 K374.16 which charge is made were ordered and
71343A tin sill 8.5 received except
722R72 4
28,852.56
20
Signature
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)
` Indianapolis, IN 46204
(/Q Phone: 317-963-1534
FEIN: 20-0994452
I
Invoice
May 01, 2014
Bill to: Barbara Lamb For: City of Carmel-Onsite
City of Carmel-Onsite Onsite/April 2014
1 Civic Square
Carmel,IN 46032-
Invoice# 733407
Proc Code Date Description
15.00
Invoice# 733407(continued)page 2
04/15/2014 Quick Read UDS/6panel includes
165.00
MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE
DATE-PLEASE INCLUDE INVOICE#ON CHECK
FMAY
mitt 052014
Clerk Treasurer
Cut and return with payment
----------------------------------------------------------------------------------------------------------------------
'VOUCHER NO.' WARRANT NO.
ALLOWED:- 20
IU Health Workplace Services, LLC
IN SUM OF$
2046 Reliable Pkwy-.....
"-'--Chicago,-IL 60686=0020
$165.00
ON ACCOUNT OF APPROPRIATION FOR 1
Carmel HR Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT..
Board Members
4201 I 733407 I 43-588.00 I $165.00 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
Monday, May 05, 2014
Director, HR
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund _,
Prescribed by State Board of Accounts City Form No.201(Rev:1995)
AMOUNTS 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
nvoice Invoice Descripfion Amount--
Date.'
mount Date Number (or note attached invoice(s)or-bill(s))
05/01/14 733407 $165.00
:I hereby certify that the attached invoice(s),or bill(s), is(are)true and correct and I have audited same in accordance
;with IC 5-11-10-1.6
20
Clerk-Treasurer
Indiana University Health Workplace Services, LLC
gyp` 950 North Meridian Street
r Suite 200 (City of Carmel)
Indianapolis, IN 46204
1 - Phone: 317-963-1534
FEIN: 20-0994452
E
Invoice
May 01, 2014
Bill to: Barbara Lamb For: City of Carmel-Onsite
City of Carmel-Onsite EAP Services/April 2014
1 Civic Square
Carmel,IN 46032-
Invoice# 733558
Proc Code p9g Description Qy Charae Receipt Adjust Balance
EAPSERV 04/01/2014 EAP Services 600.00 720.00 720.00
Balance Due: 720.00
Invoice# 733558 Balance Due: 720.00
MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE
DATE-PLEASE INCLUDE INVOICE#ON CHECK
Submitted To
ed
MAY 052014
clerk `�reesurer
�. Cut and return with payment
VOUCHER NO. WARRANT NO.
ALLOWED 20
IU Health Workplace Services, LLC
IN SUM OF$
., 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 733558 43-475.00 $720.00
1 hereby certify that the attached invoice(s), or
I
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 j
Monday, May 05, 2014
Director, Administration
Title
Cost distribution ledger classification if j
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))
05/01/14 733558 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