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Home My WebLink About232254 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