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Home My WebLink About233781 06/18/14 •♦1 ur c�yMf J/ �`. CITY OF CARMEL, INDIANA VENDOR: 367222 ONE CIVIC SQUARE IU HEALTH WORKPLACE SERVICES LLCCHECK AMOUNT: $****43,105.58* :� ?� CARMEL, INDIANA 46032 2046 RELIABLE PKWY CHECK NUMBER: 233781 �+„�TON�°` CHICAGO IL 60686-0020 CHECK DATE: 06/18/14 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1201 4358800 733696 435.00 TESTING FEES 301 5023990 733727 27,560.00 OTHER EXPENSES 1205 4347500 733728 720.00 GENERAL INSURANCE 301 5023990 733729 4,374.16 OTHER EXPENSES 301 5023990 733804 9,263.59 OTHER EXPENSES 301 5023990 733857 752.83 OTHER EXPENSES Indiana University Health Workplace Services, LLC 950 North Meridian Street Suite 200 J ) Indianapolis, IN 46204 Phone: 317-963-1534 FEIN: 20-0994452 Invoice June 02, 2014 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Onsite Fees/May 2014 1 Civic Square Carmel,IN 46032- Invoice# 733729 Proc Code Date Description (� Charae Receipt Adiust Balance CARMBUIL 05/01/2014 City of Carmel Clinic Build Out 1.00 2574.16 2574.16 CARMLEAS 05/01/2014 City of Carmel Sports Performance 1.00 1800.00 1800.00 Lease Balance Due: 4374.16 Invoice# 733729 Balance Due: 4374.16 Submifted To JUN 16 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 June 02, 2014 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Misc.Onsite/May 2014 1 Civic Square Carmel,IN 46032- Invoice# 733804 Proc Code Date Description ion Qy Charae Receipt Adiust Balance 99070 04/30/2014 Young at Heart Mail-Ins 1.00 5907.58 5907.58 99070 04/30/2014 Young at Heart Clinic Meds 1.00 791.89 791.89 99070 05/01/2014 Onsite Lab Charges 1.00 1791.91 1791.91 Apr112014 Labs 99070 05/11/2014 Young at Heart Clinic Meds 1.00 772.21 772.21 Balance Due: 9263.59 Invoice# 733804 Balance Due: 9263.59 Submitted To JUN 16 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 June 02, 2014 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Supply Billing/May 2014 1 Civic Square Carmel,IN 46032- Invoice# 733857 Proc Code Date Descri tion Cly Charge Receipt Adiust Balance 99070 05/01/2014 Onsite Operating Supplies 1.00 752.83 752.83 May 2014 Supplies Balance Due: 752.83 Invoice# 733857 Balance Due: 752.83 Submitted To JUN 16 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 Submitted To Phone: 317-963-1534 Subs FEIN: 20-0994452 JUN 16N14 Invoice Clerk TreaSU��r June 02, 2014 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Staff Time/May 2014 1 Civic Square Carmel,IN 46032- Invoice# 733727 Proc Code Date Descri tion -Qty Charae Receipt Adiust Balance NURSEMA 05/01/2014 M.A.Staff Time 4.00 112.00 112.00 Kimberly Pride NURSEMD 05/01/2014 MD Staff Time 4.00 700.00 700.00 Dr.Fagan NURSERN 05/01/2014 R.N.Staff Time 4.00 248.00 248.00 Mareesa Martin NURSEMA 05/02/2014 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride NURSEMD 05/02/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 05/02/2014 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 05/05/2014 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride NURSEMD 05/05/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 05/05/2014 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 05/06/2014 M.A.Staff Time 6.00 168.00 168.00 Kimberly Pride NURSEMD 05/06/2014 MD Staff Time 6.00 1050.00 1050.00 Dr.Fagan NURSERN 05/06/2014 R.N.Staff Time 6.00 372.00 372.00 Mareesa Martin NURSEMA 05/07/2014 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride NURSEMD 05/07/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 05/07/2014 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 05/08/2014 M.A.Staff Time 4.00 112.00 112.00 Kimberly Pride NURSEMD 05/08/2014 MD Staff Time 4.00 700.00 700.00 Dr.Fagan NURSERN 05/08/2014 R.N.Staff Time 4.00 248.00 248.00 Mareesa Martin NURSEMA 05/09/2014 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride Invoice# 733727(continued)page 2 NURSEMD 05/09/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 05/09/2014 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 05/12/2014 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride NURSEMD 05/12/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 05/12/2014 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 05/13/2014 M.A.Staff Time 6.00 168.00 168.00 Kimberly Pride NURSEMD 05/13/2014 MD Staff Time 6.00 1050.00 1050.00 Dr.Fagan NURSERN 05/13/2014 R.N.Staff Time 6.00 372.00 372.00 Mareesa Martin NURSEMA 05/14/2014 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride NURSEMD 05/14/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 05/14/2014 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 05/15/2014 M.A.Staff Time 4.00 112.00 112.00 Kimberly Pride NURSEMD 05/15/2014 MD Staff Time 4.00 700.00 700.00 Dr.Fagan NURSERN 05/15/2014 R.N.Staff Time 4.00 248.00 248.00 Mareesa Martin NURSEMA 05/16/2014 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride NURSEMD 05/16/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 05/16/2014 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 05/19/2014 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride NURSEMD 05/19/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 05/19/2014 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 05/20/2014 M.A.Staff Time 6.00 168.00 168.00 Kimberly Pride NURSEMD 05/20/2014 MD Staff Time 6.00 1050.00 1050.00 Dr.Fagan NURSERN 05/20/2014 R.N.Staff Time 6.00 372.00 372.00 Mareesa Martin NURSEMA 05/21/2014 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride NURSEMD 05/21/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 05/21/2014 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 05/22/2014 M.A.Staff Time 4.00 112.00 112.00 Kimberly Pride NURSEMD 05/22/2014 MD Staff Time 4.00 700.00 700.00 Dr.Fagan NURSERN 05/22/2014 R.N.Staff Time 4.00 248.00 248.00 Mareesa Martin Invoice# 733727(continued)page 3 NURSEMA 05/23/2014 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride NURSEMD 05/23/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 05/23/2014 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 05/27/2014 M.A.Staff Time 6.00 168.00 168.00 Kimberly Pride NURSEMD 05/27/2014 MD Staff Time 6.00 1050.00 1050.00 Dr.Fagan NURSERN 05/27/2014 R.N.Staff Time 6.00 372.00 372.00 Mareesa Martin NURSEMA 05/28/2014 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride NURSEMD 05/28/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 05/28/2014 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 05/29/2014 M.A.Staff Time 4.00 112.00 112.00 Kimberly Pride NURSEMD 05/29/2014 MD Staff Time 4.00 700.00 700.00 Dr.Fagan NURSERN 05/29/2014 R.N.Staff Time 4.00 248.00 248.00 Mareesa Martin NURSEMA 05/30/2014 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride NURSEMD 05/30/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 05/30/2014 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin Balance Due: 27560.00 Invoice# 733727 Balance Due: 27560.00 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)) 06/02/14 722 7 9 A Fees! May 2014 4,374.16 06/02/14 732 8 0 4 nsitel May 20 14 9,263.59 08109114 723857 SUPP y BilliAg!May 2014 752.83 ng/og/14 733797 Staff Time/May 2014 27,560.00 Total 41,950.58 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. 120- Clerk-Treasurer 20Clerk-Treasurer VOUCHER NOQ6i16i14 WARRANT NO. ALLOWED 20 I U Health Workplace Services, LLC, IN SUM OF $ 2046 Reliable Pkwy Chicago, IL 60686-0020 '1 $ 41 ,950.58 ON ACCOUNT OF APPROPRIATION FOR j 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 733729 301 $4,374.16 which charge is made were ordered and 733804 301 $9,263.59 received except 73385713752,83 733727 ini 20 Ignature Cost distribution ledger classification if Title claim paid motor vehicle highway fund Indiana University Health Workplace Services, LLC - 950 North Meridian Street 2�s Suite 200 (City of Carmel) Indianapolis, IN 46204 Phone: 317-963-1534 FEIN: 20-0994452 Invoice June 02, 2014 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite EAP Services/May 2014 l Civic Square Carmel,IN 46032- Invoice# 733728 Proc Code Date Description C� Charae Receipt Adiust Balance EAPSERV 05/01/2014 EAP Services 600.00 720.00 720.00 Balance Due: 720.00 Invoice# 733728 Balance Due: 720.00 Submitted To JUN 16 2014 - lerk Treasurer A Cut and return with payment VOUCHER NO. WARRANT NO. i IU Health Workplace Services, LLC ALLOWED 20 IN SUM OF$ 2046 Reliable Pkwy Chicago, IL 60686-0020 i $720.00 ON ACCOUNT OF APPROPRIATION FOR Administration Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1205 I 733728 I 43-475.00 I $720.00 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, June 16, 2014 I Director, Administrati n 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)or bill(s)) 06/02/14 733728 EAP Services $720.00 I hereby certify that the attached invoice(s), or bill(s), is(are)true and correct and I have audited same in accordance with IC 5-11-10-1.6 20 Clerk-Treasurer Indiana University Health Workplace Services,LLC 950 North Meridian Street 12�\ Suite 200 (City of Carmel) Indianapolis, IN 46204 Submitted To Phone: 317-963-1534 y� FEIN: 20-0994452 JUN x,2014 Clerk Treasurer Invoice June 02, 2014 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Onsite/May 2014 1 Civic Square Carmel,IN 46032- Invoice# 733696 Proc Code Date Description 15.00 Invoice# 733696(continued)page 2 05/20/2014 Quick Read UDS/6panel includes 15.00 kit Invoice# 733696(continued)page 3 435.00 Cut and return with navment VOUCHER NO. WARRANT NO. ALLOWED 20 IU Health Workplace Services, LLC IN SUM OF$ 2046 Reliable Pkwy Chicago, IL 60686-0020 $435.00 ON ACCOUNT OF APPROPRIATION FOR Carmel HR Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1201 I 733696 I 43-588.00 I $435.00 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 which charge is made were ordered and received except I Monday, June 16, 2014 IDirector, HR Title I Cost distribution ledger classification if claim paid motor vehicle highway fund I 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)) 06/02/14 733696 Onsite Testing $435.00 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