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Home My WebLink About23U9/4 11/05/14 (9, CITY OF CARMEL, INDIANA VENDOR: 367222 ONE CIVIC SQUARE IU HEALTH WORKPLACE SERVICES LLCCHECK AMOUNT: $`•''35,065.80" CARMEL, INDIANA 46032 2046 RELIABLE PKWY CHECK NUMBER: 238974 CHICAGO IL 60686-0020 CHECK DATE: 11/05/14 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 301 5023990 736819 28,930.00 OTHER EXPENSES 301 5023990 736947 4,374.16 OTHER EXPENSES 301 5023990 737295 1,761.64 OTHER EXPENSES Indiana University Health Workplace Services, LLC -3o) 950 North Meridian Street Suite 950 Indianapolis, IN 46204 Phone: 317-963-1535 FEIN: 20-0994452 Invoice November 03, 2014 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Onsite Fees/Oct.2014 1 Civic Square Carmel,IN 46032- Invoice# 736947 Proc Code pate, Aescri tP ion SSC Charge Receipt $dust Balance CARMBUIL 10/01/2014 City of Carmel Clinic Build Out 1.00 2574.16 2574.16 CARMLEAS 10/01/2014 City of Carmel Sports Performance 1.00 1800.00 1800.00 Lease Balance Due: 4374.16 Invoice# 736947 Balance Due: 4374.16 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK Indiana University Health Workplace Services, LLC 950 North Meridian Street Suite 950 (City of Carmel) Indianapolis, IN 46204 Phone: 317-963-1535 FEIN: 20-0994452 Invoice November 03, 2014 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Supply Billing/Oct.2014 1 Civic Square Carmel,IN 46032- Invoice# 737295 Proc Code Date Description Charge ReceipBalance 99070 10/01/2014 Onsite Operating Supplies 1.00 1761.64 1761.64 October 2014 Supplies i Balance Due: 1761.64 Invoice# 737295 Balance Due: 1761.64 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK �, _ Gut and retam with payment Indiana University Health Workplace Services,LLC 950 North Meridian Street Suite 950 (City of Carmel) Indianapolis, IN 46204 Phone: 317-963-1535 FEIN: 20-0994452 Invoice November 03, 2014 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Staff Time/Oct.2014 1 Civic Square Carmel,IN 46032- Invoice# 736819 Proc Code Date Description Qy Charoe Receipt Adiust Balance NURSEMA 10/01/2014 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride NURSEMD 10/01/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 10/01/2014 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 10/02/2014 M.A.Staff Time 4.00 112.00 112.00 Kimberly Pride NURSEMD 10/02/2014 MD Staff Time 4.00 700.00 700.00 Dr.Fagan NURSERN 10/02/2014 R.N.Staff Time 4.00 248.00 248.00 Mareesa Martin NURSEMA 10/03/2014 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride NURSEMD 10/03/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 10/03/2014 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 10/06/2014 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride NURSEMD 10/06/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 10/06/2014 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 10/07/2014 M.A.Staff Time 6.00 168.00 168.00 Kimberly Pride NURSEMD 10/07/2014 MD Staff Time 6.00 1050.00 1050.00 Dr.Fagan NURSERN 10/07/2014 R.N.Staff Time 6.00 372.00 372.00 Mareesa Martin NURSEMA 10/08/2014 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride NURSEMD 10/08/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 10/08/2014 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 10/09/2014 M.A.Staff Time 4.00 112.00 112.00 Kimberly Pride Invoice# 736819(continued)page 2 NURSEMD 10/09/2014 MD Staff Time 4.00 700.00 700.00 Dr.Fagan NURSERN 10/09/2014 R.N.Staff Time 4.00 248.00 248.00 Mareesa Martin NURSEMA 10/10/2014' M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride NURSEMD 10/10/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 10/10/2014 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 10/13/2014 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride NURSENP 10/13/2014 N.P.Staff Time 5.00 475.00 475.00 Randi Antworth NURSERN 10/13/2014 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 10/14/2014 M.A.Staff Time 6.00 168.00 168.00 Kimberly Pride NURSENP 10/14/2014 N.P.Staff Time 6.00 570.00 570.00 Randi Antworth NURSERN 10/14/2014 R.N.Staff Time 6.00 372.00 372.00 Mareesa Martin NURSEMA 10/15/2014 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride NURSENP 10/15/2014 N.P.Staff Time 5.00 475.00 475.00 Randi Antworth NURSERN 10/15/2014 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 10/16/2014 M.A.Staff Time 4.00 112.00 112.00 Kimberly Pride NURSEMD 10/16/2014 MD Staff Time 4.00 700.00 700.00 Dr.Fagan NURSERN 10/16/2014 R.N.Staff Time 4.00 248.00 248.00 Mareesa Martin NURSEMA 10/17/2014 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride NURSEMD 10/17/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 10/17/2014 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 10/20/2014 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride NURSEMD 10/20/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 10/20/2014 R.N.Staff Time 5.00 310.00 310.00 Betty Hartley NURSEMA 10/21/2014 M.A.Staff Time 6.00 168.00 168.00 Kimberly Pride NURSEMD 10/21/2014 MD Staff Time 6.00 1050.00 1050.00 Dr.Fagan NURSERN 10/21/2014 R.N.Staff Time 6.00 372.00 372.00 Nicole Jackson NURSEMA 10/22/2014 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride NURSEMD 10/22/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 10/22/2014 R.N.Staff Time 5.00 310.00 310.00 Nicole Jackson Invoice# 736819(continued)page 3 NURSEMA 10/23/2014 M.A.Staff Time 4.00 112.00 112.00 Kimberly Pride NURSEMD 10/23/2014 MD Staff Time 4.00 700.00 700.00 Dr.Fagan NURSERN 10/23/2014 R.N.Staff Time 4.00 248.00 248.00 Mareesa Martin NURSEMA 10/24/2014 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride NURSEMD 10/24/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 10/24/2014 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 10/27/2014 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride NURSEMD 10/27/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 10/27/2014 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 10/28/2014 M.A.Staff Time 6.00 168.00 168.00 Kimberly Pride NURSEMD 10/28/2014 MD Staff Time 6.00 1050.00 1050.00 Dr.Fagan NURSERN 10/28/2014 R.N.Staff Time 6.00 372.00 372.00 Mareesa Martin NURSEMA 10/29/2014 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride NURSEMD 10/29/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 10/29/2014 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 10/30/2014 M.A.Staff Time 4.00 112.00 112.00 Kimberly Pride NURSEMD 10/30/2014 MD Staff Time 4.00 700.00 700.00 Dr.Fagan NURSERN 10/30/2014 R.N.Staff Time 4.00 248.00 248.00 Mareesa Martin NURSEMA 10/31/2014 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride NURSEMD 10/31/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 10/31/2014 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin Balance Due: 28930.00 Invoice# 736819 Balance Due: 28930.00 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK l Invoice# 736819(continued)page 4 - I,1 Cut and return with payment ------------------------------------------------------------- ----------------------------------------- Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form 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)) 4,374.16 11/03/14 1 11/03/1 ,761.64 28,930.00 11/03/14 736b19 0,isite Staff Time!Oet 2014 35,065. 0 Total I hereby certify that the attached invoice(s), or bill(s), is (are)true and correct and I have audited same in accor- dance with IC 5-11-10-1.6. , 20- Clerk-Treasurer 20Clerk-Treasurer VOUCHER N00/05/14 WARRANT NO. ALLOWED 20 IU Health Workplace Services, LLC IN SUM OF $ 2046 Reliable Pkwy Chicago, IL 60686-0020 $35,065.80 ON ACCOUNT OF APPROPRIATION FOR 301 Medical Fund Board Members PO#or DEPT.# INVOICE NO. ACCT#/TITLE AMOUNT I hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and that the materials or services itemized thereon 736947 301 4,374.16 for which charge is made were ordered and received except 737295 $1,761.64 I i i i 20 Signature Title Cost distribution ledger classification if claim paid motor vehicle highway fund i