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Home My WebLink About236901 09/10/14 0o!.cry �% \f. CITY OF CARMEL, INDIANA VENDOR: 367222 ONE CIVIC SQUARE IU HEALTH WORKPLACE SERVICES LLCCHECK AMOUNT: $"`*48,563.41' _� CARMEL, INDIANA 46032 2046 RELIABLE PKWY CHECK NUMBER: 236901 +MUTON�` CHICAGO IL 60686-0020 CHECK DATE: 09/10/14 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1201 4358800 735352 120.00 TESTING FEES 301 5023990 735471 27,713.00 OTHER EXPENSES 1205 4347500 735472 720.00 GENERAL INSURANCE 301 5023990 735473 4,374.16 OTHER EXPENSES 301 5023990 735667 14,005.16 OTHER EXPENSES 301 5023990 735849 1,631.09 OTHER EXPENSES Indiana University Health Workplace Services,LLC 950 North Meridian Street s� Suite 200 (City of Carmel) Indianapolis, IN 46204 Phone: 317-963-1534 FEIN: 20-0994452 Invoice September 02, 2014 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Onsite/August 2014 1 Civic Square Carmel,IN 46032- _ ____.._ . .--- ,._.__ __._..--- -- Invoice# 735352 Proc Code Date Descriotion 15.00 08/26/2014 Quick Read UDS/6panel includes 15.00 Invoice# 735352 Balance Due: 120.00 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK Invoice# 735352(continued)page 2 i Submitted To SEP 0.8 2014 Clerk Treasurer h Cut and return with payment VOUCHER NO. WARRANT NO. ALLOWED 20 IU Health Workplace Services, LLC IN SUM OF$ 2046 Reliable Pkwy Chicago, IL 60686-0020 $120.00 ON ACCOUNT OF APPROPRIATION FOR Carmel HR Department PO#/Dept. INVOICE NO. ACCT#frITLE AMOUNT Board Members 1201 I 735352 I 43-588.00 I $120.00 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, September 08, 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) 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)) 09/02/14 735352 Drug Tests $120.00 I hereby certify that the attached invoice(s), or bill(s), is(are)true and correct and I have audited same in accordance with IC 5-11-10-1.6 20 Clerk-Treasurer Indiana University Health Workplace Services, LLC 950 North Meridian Street l Zas Suite 200 (City of Carmel) Indianapolis, IN 46204 Phone: 317-963-1534 FEIN: 20-0994452 Invoice September 02, 2014 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite EAP Services/August 2014 1 Civic Square Carmel,IN 46032- _._.. ... m__..._ _.._.,.. ___. _._. ._... . . u_.....__ N m..r.� _...w__.._ a..._. __.... Invoice# 735472 Proc Code Date Description City Charge Receipt Adjust Balance EAPSERV 08/01/2014 EAP Services 600.00 720.00 720.00 600 Employees Balance Due: 720.00 Invoice# 735472 Balance Due: 720.00 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK S>ubmifted To SEP 0 8 2014 Clerk Treasurer Cut and return with payment VOUCHER NO. WARRANT NO. ALLOWED 20 IU Health Workplace Services, LLC IN SUM OF$ 2046 Reliable Pkwy Chicago, IL 60686-0020 $720.00 ON ACCOUNT OF APPROPRIATION FOR Administration Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1205 I 735472 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 I Monday, September 08, 2014 f 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)or bill(s)) 09/02/14 735472 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 Suite 200 Indianapolis, IN 46204 Phone: 317-963-1534 FEIN: 20-0994452 Invoice September 02, 2014 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Onsite Fees/August 2014 1 Civic Square Carmel,IN 46032- Invoice# 735473 Proc Code Date Description C-ty Charge Recei t Adjust Balance CARMBUIL 08/01/2014 City of Carmel Clinic Build Out 1.00 2574.16 2574.16 CARMLEAS 08/01/2014 City of Carmel Sports Performance 1.00 1800.00 1800.00 Lease Balance Due: 4374.16 Invoice# 735473 Balance Due: 4374.16 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK Submitted To SEP 0 82014 Clerk Treasurer Cut and return with a mcnt 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 September 02, 2014 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Misc.Onsite/Aug.2014 1 Civic Square Carmel,IN 46032- . Invoice# 735667 Proc Code Date DescriptionCyt Charge Receipt Adiust Balance 99070 07/20/2014 Young at Heart Mail-Ins 1.00 2115.21 2115.21 99070 07/31/2014 Young at Heart Mail-Ins 1.00 4758.59 4758.59 99070 07/31/2014 Young at Heart Clinic Meds 1.00 778.19 778.19 99070 08/01/2014 Onsite Lab Charges 1.00 2297.58 2297.58 Auly 2014 Labs 99199 08/01/2014 Miscellaneous Charge 1.00 251.84 251.84 Dish Network Installation 99070 08/17/2014 Young at Heart Mail-Ins 1.00 3803.75 3803.75 Balance Due: 14005.16 Invoice# 735667 Balance Due: 14005.16 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK mitted To To Fr P 0 8 2014 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 September 02, 2014 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Supply Billing/Aug.2014 1 Civic Square Carmel,IN 46032- ._ Invoice# 735849 Proc Code Date Description City Charae Recei t Adjust Balance 99070 08/01/2014 Onsite Operating Supplies 1.00 1631.09 1631.09 August 2014 Supplies Balance Due: 1631.09 Invoice# 735849 Balance Due: 1631.09 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK submitted To SEP 0 8 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 FEIN: 20-0994452 �- SEP 0 8 2014 Invoice Clerk 1 reasurer September 02, 2014 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Staff Time/August 2014 1 Civic Square Carmel,IN 46032- Invoice# 735471 Proc Code Date Description City Charge Receipt Adjust Balance NURSEMA 08/01/2014 M.A.Staff Time 5.00 140.00 140.00 Michelle Hall NURSEMD 08/01/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 08/01/2014 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 08/04/2014 M.A.Staff Time 5.00 140.00 140.00 Desire Riedy NURSEMD 08/04/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 08/04/2014 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 08/05/2014 M.A.Staff Time 6.00 168.00 168.00 Desire Riedy NURSEMD 08/05/2014 MD Staff Time 6.00 1050.00 1050.00 Dr.Fagan NURSERN 08/05/2014 R.N.Staff Time 6.00 372.00 372.00 Mareesa Martin NURSEMA 08/06/2014 M.A.Staff Time 5.00 140.00 140.00 Desire Riedy NURSEMD 08/06/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 08/06/2014 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin NURSEMD 08/07/2014 MD Staff Time 4.00 700.00 700.00 Dr.Fagan NURSERN 08/07/2014 R.N.Staff Time 4.00 248.00 248.00 Mareesa Martin NURSEMA 08/08/2014 M.A.Staff Time 5.00 140.00 140.00 Desire Riedy NURSEMD 08/08/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 08/08/2014 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 08/11/2014 M.A.Staff Time 5.00 140.00 140.00 Desire Riedy NURSEMD 08/11/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan Invoice# 735471 (continued)page 2 ........... ..............--................ ............ ............................... NURSERN 08/11/2014 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 08/12/2014 M.A.Staff Time 6.00 168.00 168.00 Desire Riedy NURSEMD 08/12/2014 MD Staff Time 6.00 1050.00 1050.00 Dr.Fagan NURSERN 08/1212014 R.N.Staff Time 6.00 372.00 372.00 Mareesa Martin NURSEMA 08/13/2014 M.A.Staff Time 5.00 140.00 140.00 Desire Riedy NURSEMD 08/13/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 08/13/2014 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 08/14/2014 M.A.Staff Time 4.00 112.00 112.00 Desire Riedy NURSEMD 08/14/2014 MD Staff Time 4.00 700.00 700.00 Dr.Fagan NURSERN 08/14/2014 R.N.Staff Time 4.00 248.00 248.00 Mareesa Martin NURSEMA 08/15/2014 M.A.Staff Time 5.00 140.00 140.00 Desire Riedy NURSEMD 08/15/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 08/15/2014 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 08/18/2014 M.A.Staff Time 5.00 140.00 140.00 Desire Riedy NURSEMD 08/18/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 08/18/2014 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 08/19/2014 M.A.Staff Time 6.00 168.00 168.00 Desire Riedy NURSEMD 08/19/2014 MD Staff Time 6.00 1050.00 1050.00 Dr.Fagan NURSERN 08/19/2014 R.N.Staff Time 6.00 372.00 372.00 Mareesa Martin NURSEMA 08/20/2014 M.A.Staff Time 5.00 140.00 140.00 Desire Ried), NURSEMD 08/20/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 08/20/2014 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 08/21/2014 M.A.Staff Time 4.00 112.00 112.00 Desire Riedy NURSEMD 08/2112014 MD Staff Time 4.00 700.00 700.00 Dr.Fagan NURSERN 08/21/2014 R.N.Staff Time 4.00 248.00 248.00 Mareesa Martin NURSEMA 08/22/2014 M.A.Staff Time 5.00 140.00 140.00 Desire Riedy NURSEMD 08/22/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 08/22/2014 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 08/25/2014 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride Invoice# 735471 (continued)page 3 NURSEMD 08/25/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 08/25/2014 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 08/26/2014 M.A.Staff Time 6.00 168.00 168.00 Kimberly Pride NURSEMD 08/26/2014 MD Staff Time 6.00 1050.00 1050.00 Dr.Fagan NURSERN 08/26/2014 R.N.Staff Time 6.00 372.00 372.00 Mareesa Martin NURSEMA 08/27/2014 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride, NURSEMD 08/27/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 08/27/2014 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 08/28/2014 M.A.Staff Time 4.00 112.00 112.00 Kimberly Pride NURSEMD 08/28/2014 MD Staff Time 4.00 700.00 700.00 Dr.Fagan NURSERN 08/28/2014 R.N.Staff Time 4.00 248.00 248.00 Mareesa Martin NURSEMA 08/29/2014 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride NURSEMD 08/29/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 08/29/2014 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin Balance Due: 27713.00 Invoice# 735471 Balance Due: 27713.00 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 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)) 09/01/14 735,473 Onsite Fees!Aug 2014 4,374.16 09101114 735667 R.Aisc Qnsitel Aug 2014 14,005.15 09/01/14 735849 Supp! gilliRg!Aug 2014 1,631.09 Total 47,723.41 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 N(:b ljA—WARRANT NO. I ALLOWED 20 IU Health Workplace Services, LLC IN SUM OF $ 2046 Reliable Pkwy Chicago, IL 60686-0020 $_ 47,723.41 ON ACCOUNT OF APPROPRIATION FOR I i i 301 Medical Fund Board Members i 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 735473 301 $4,374.16 j which charge is made were ordered and 735667 $14,005.16 j received except TASR4A 301 S1 R31 nqI 73547:1-- 27,71300 20 Signature Cost distribution ledger classification if Title claim paid motor vehicle highway fund