HomeMy WebLinkAbout236901 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