The URL can be used to link to this page

Home My WebLink About240020 12/09/2014 (9, ) CITY OF CARMEL, INDIANA VENDOR: 367222 ONE CIVIC SQUARE IU HEALTH WORKPLACE SERVICES LLCCHECK AMOUNT: $"'`38,608.57' CARMEL, INDIANA 46032 2046 RELIABLE PKWY CHECK NUMBER: 240020 CHICAGO IL 60686-0020 CHECK DATE: 12/09/14 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1120 4230100 736900 600.00 STATIONARY & PRNTD MA 1120 4230100 737088 7,007.43 STATIONARY & PRNTD MA 1120 4230100 737585 22,525.00 STATIONARY & PRNTD MA 1205 4347500 737620 720.00 GENERAL INSURANCE 1120 4230100 737621 4,374.16 STATIONARY & PRNTD MA 1201 4358800 737960 22.00 TESTING FEES 1120 4230100 738015 681.14 STATIONARY & PRNTD MA 1120 4230100 738016 2,378.84 STATIONARY & PRNTD MA 1120 4350900 738016 300.00 OTHER CONT SERVICES Indiana University Health Workplace Services, LLC X20 950 North Meridian Street Suite 950 (City of Carmel) Indianapolis, IN 46204 Phone: 317-963-1535 FEIN: 20-0994452 Invoice December 01, 2014 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Onsite/Nov.2014 1 Civic Square Carmel,IN 46032- Invoice# 737960 Proc Code Date Description SSC Charae Receipt A&-$I Balance 80100 11/24/2014 Regulated Drug Screen 3alance Due: 22.00 Invoice# 737960 Balance Due: 22.00 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK Submitted To DEC 082014 Clelm Treasurer avment VOUCHER` . WARRANT NO. ALLOWED 20 IU Health Workplace Services, LLC IN SUM OF$ 2046 Reliable Pkwy Chicago, IL 60686-0020 $22.00 ON ACCOUNT OF APPROPRIATION FOR Carmel HR Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1201 I 737960 I 43-588.00 I $22.00 '1 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, December 08, 2014 A� .- 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 Descripfion Amount ` Date Nu,mber` (or note attached invoice(s):or bill(s)). 12/01/14 737960 ., . $22.00 I hereby certify that the attached invoice(s), or.bill(s), is(are)'true and correct and I have audited same in accordance with IC 5-11-10-1.6 20 Clerk-Treasurer Ll�s Indiana University Health Workplace Services, LLC 950 North Meridian Street 1Z�s Suite 950 (City of Carmel) Indianapolis, IN 46204 Phone: 317-963-1535 FEIN: 20-0994452 Invoice December 01, 2014 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite EAP Services/Nov.2014 1 Civic Square Carmel,IN 46032- Invoice# 737620 Proc Code Date Descri tp ion CSC Charge Receipt Adjust Balance EAPSERV 11/01/2014 EAP Services 600.00 720.00 720.00 600 Employees Balance Due: 720.00 Invoice# 737620 Balance Due: 720.00 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK Submitted To DEC 0 8 2014 Clerk Treasurer Cut and return with payment VOUCHER NO: WARRANT NO. ALLOWED 20 IU Health Workplace Services, LLC IN SUM OF$ 2046.,Reliable Pkwy Chicago,-IL 60686-0020 $720.00 = . . .. •I ON ACCOUNT OF APPROPRIATION FOR Administration Department PO#/Dept. INVOICENO. ACCT#/TITLE AMOUNT Board Members, 1205 I- 737620 I 43-475:00 I $720:00 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, December 08, 2014 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)) 12/01/14 737620: 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 Invoice# 737585(continued)page 3 NURSEMA 11/26/2014 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride NURSEMD 11/26/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 11/26/2014 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin Balance Due: 22525.00 Invoice# 737585 Balance Due: 22525.00 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK �, Cut and return with payment Indiana University Health Workplace Services,LLC 1 950 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 Misc.Onsite/Oct.2014 1 Civic Square Carmel,IN 46032- Invoice# 737088 Proc Code pmtg Description -QIY Charge Receipt Adiust Balance 99070 05/11/2014 Young at Heart Mail-Ins 1.00 585.68 585.68 99070 05/31/2014 Young at Heart Mail-Ins 1.00 2824.31 2824.31 99070 09/21/2014 Young at Heart Clinic Meds 1.00 450.74 450.74 99070 10/01/2014 Onsite Lab Charges 1.00 3146.70 3146.70 September 2014 SBMFLabs Balance Due: 7007.43 Invoice# 737088 Balance Due: 7007.43 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK Submitted To DEC 0.8 2014 Clergy; Treasurer Cut and return with payment Indiana University Health Workplace Services, LLC 950 North Meridian Street Suite 950 (City of Carmel) Indianapolis, IN 46204 Submitted TO Phone: 317-963-1535 FEIN: 20-0994452 DEC 0 S 2014 Invoice Clerk Treasurer November 03, 2014 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Carmel Physicals/Oct.2014 1 Civic Square Carmel,IN 46032- Invoice# 736900 Proc Code p3-tQ Balance Due: 600.00 Invoice# 736900 Balance Due: 600.00 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK Cut and return with payment Indiana University Health Workplace Services, LLC 950 North Meridian Street Suite 950 Indianapolis, IN 46204 Phone: 317-963-1535 FEIN: 20-0994452 Invoice December 01, 2014 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Onsite Fees/Nov.2014 1 Civic Square Carmel,IN 46032- Invoice# 737621 Proc Code Date Description .Qty Charoe Receipt Adiust Balance CARMBUIL 11/01/2014 City of Carmel Clinic Build Out 1.00 2574.16 2574.16 CARMLEAS 11/01/2014 City of Carmel Sports Performance 1.00 1800.00 1800.00 Lease Balance Due: 4374.16 Invoice# 737621 Balance Due: 4374.16 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK Submitted To DEC 4 8 2014 Clerk p reasurer w �, Cut and return 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 December 01, 2014 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Misc.Onsite/Nov.2014 1 Civic Square Cannel,IN 46032- Invoice# 738016 Proc Code Date Description -Qty Charge Receipt Adjust Balance 10/01/2014 Stress Test 1.00 250.00 250.00 99070 10/12/2014 Young at Heart Clinic Meds 1.00 1126.70 1126.70 99070 10/26/2014 Young at Heart Clinic Meds 1.00 614.34 614.34 99070 10/31/2014 Young at Heart Clinic Meds 1.00 437.80 437.80 11/10/2014 Stress Test 1.00 250.00 250.00 Balance Due: 2678.84 Invoice# 738016 Balance Due: 2678.84 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK E�erk, itted To 1 0,8 2014 rees�r�r Cut and return 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 December 01, 2014 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Supply Billing/Nov.2014 1 Civic Square Carmel,IN 46032- Invoice# 738015 Proc Code Date Descri tp ion Cly Charge Receipt Adiust Balance 99070 11/01/2014 Onsite Operating Supplies 1.00 681.14 681.14 November 2014 Supplies Balance Due: 681.14 Invoice# 738015 Balance Due: 681.14 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK 0 SSubmitted TO DEC 4 8 2014 Clare Treasurer Cut and return with payment Indiana University Health Workplace Services,LLC 950 North Meridian Street Suite 950 (City of Carmel) 9 Indianapolis, IN 46204 S:nittedO Phone: 317-963-1535 FEIN: 20-0994452 4 Invoice December 01, 2014 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Staff Time/Nov.2014 1 Civic Square Carmel,IN 46032- Invoice# 737585 Proc Code Date Description -QtY Charge Receipt Adjust Balance NURSEMA 11/03/2014 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride NURSEMD 11/03/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 11/03/2014 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 11/04/2014 M.A.Staff Time 6.00 168.00 168.00 Kimberly Pride NURSEMD 11/04/2014 MD Staff Time 6.00 1050.00 1050.00 Dr.Fagan NURSERN 11/04/2014 R.N.Staff Time 6.00 372.00 372.00 Mareesa Martin NURSEMA 11/05/2014 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride NURSEMD 11/05/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan 11/05/2014 R.N.Staff Time 5.00 NURSERN 310.00 310.00 Mareesa Martin NURSEMA 11/06/2014 M.A.Staff Time 4.00 112.00 112.00 Kimberly Pride NURSEMD 11/06/2014 MD Staff Tune 4.00 700.00 700.00 Dr.Fagan NURSERN 11/06/2014 R.N.Staff Time 4.00 248.00 248.00 Mareesa Martin NURSEMA 11/07/2014 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride NURSEMD 11/07/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 11/07/2014 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 11/10/2014 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride NURSEMD 11/10/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 11/10/2014 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 11/12/2014 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride Invoice# 737585 (continued)page 2 NURSEMD 11/12/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 11/12/2014 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 11/13/2014 M.A.Staff Time 4.00 112.00 112.00 Kimberly Pride NURSEMD 11/13/2014 MD Staff Time 4.00 700.00 700.00 Dr.Fagan NURSERN. 11/13/2014 R.N.Staff Time 4.00 248.00 248.00 Mareesa Martin NURSEMA 11/14/2014 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride NURSEMD 11/14/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 11/14/2014 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 11/17/2014 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride NURSEMD 11/17/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 11/17/2014 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 11/18/2014 M.A.Staff Time 6.00 168.00 168.00 Kimberly Pride NURSEMD 11/18/2014 MD Staff Time 6.00 1050.00 1050.00 Dr.Fagan NURSERN 11/18/2014 R.N.Staff Time 6.00 372.00 372.00 Mareesa Martin NURSEMA 11/19/2014 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride NURSEMD 11/19/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 11/19/2014 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 11/20/2014 M.A.Staff Time 4.00 112.00 112.00 Kimberly Pride NURSEMD 11/20/2014 MD Staff Time 4.00 700.00 700.00 Dr.Fagan NURSERN 11/20/2014 R.N.Staff Time 4.00 248.00 248.00 Mareesa Martin NURSEMA 11/21/2014 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride NURSEMD 11/21/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 11/21/2014 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 11/24/2014 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride NURSEMD 11/24/2014 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 11/24/2014 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 11/25/2014 M.A.Staff Time 6.00 168.00 168.00 Kimberly Pride NURSEMD 11/25/2014 MD Staff Time 6.00 1050.00 1050.00 Dr.Fagan NURSERN 11/25/2014 R.N.Staff Time 6.00 372.00 372.00 Mareesa Martin 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)) 14,374. 6 1 -HIR 2,376.84 1 - Fore Dept 300.00 12/01t14 738015 Supply Bijjii i9t Nov 2014 681.14 12/0V14 737585 taff Ti,,iet Nov 2014 22,525.00 11/03114 737088 asite/Oct 2014 7,007.43 11103/14 736900 hysicals/Out 2014 600.00 Total 37,866.57 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 VOUCHER-N,9844- WARRANT NO. ALLOWED 20 Q Health Workplace Services, LLC IN SUM OF $ i 2046 Reliable Pkwy Chicago, IL 60686-0020 31.866.57 ON ACCOUNT OF APPROPRIATION FOR i 301 Medical Fund r !' Board Members PO#or INVOICE NO. ACCT#/TITLE AMOUNT DEPT.# I hereby certify that the attached invoice(s), I' j or bill(s) is (are) true and correct and that ithe materials or services itemized thereon 737621 $4374.16 for which charge is made were ordered and 738016 201 $9 received except i; 19.99 I 0ou 10 301 737585 301 737088 301 7,007.43 736900 301 60).00 i 4 20 Signature Cost distribution ledger classification if j Title claim paid motor vehicle highway fund