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Home My WebLink About242020 02/10/15 i 5�q CITY OF CARMEL, INDIANA VENDOR: 367222 ® Y:; ONE CIVIC SQUARE IU HEALTH WORKPLACE SERVICES LLCCHECK AMOUNT: $'""*49,494.27 :. CARMEL, INDIANA 46032 2046 RELIABLE PKWY CHECK NUMBER: 242020 CHICAGO IL 60686-0020 CHECK DATE: 02/10/15 v ETON� DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1201 4358800 738964 15.00 TESTING FEES 301 5023990 739288 26,770.00 OTHER EXPENSES 1205 4347500 739436 692.40 GENERAL INSURANCE 301 5023990 739437 4,374.16 OTHER EXPENSES 301 5023990 739448 16,348.85 OTHER EXPENSES 301 5023990 739584 1,293.86 OTHER EXPENSES Indiana University Health Workplace Services,LLC- 950 LC950 North Meridian Street Suite 950 (City of Carmel) Indianapolis, IN 46204 2 Phone: 317-963-1535 FEIN: 20-0994452 Invoice February 02, 2015 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Onsite/Jan.2015 1 Civic Square Carmel,IN 46032- Invoice# 738964 Proc Code Date Description Q!C Charge Recei us Balance 01/05/2015 Quick Read UDS/6pane1 includes 1.00 15.00 15.00 kit Clayton Bell XXX-XY Balance Due: 15.00 Invoice# 738964 Balance Due: 15.00 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK Submitted To FEB 0 9 2014 Clerk 'Treasurer VOUCHER NO. WARRANT NO. ALLOWED 20 IU Health Workplace Services, LLC IN SUM OF$ 2046 Reliable Pkwy Chicago, IL 60686-0020 $15.00 ON ACCOUNT OF APPROPRIATION FOR Carmel HR Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1201 I 738964 I 43-588.00 I -$15.00 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 i which charge is made were ordered and received except Monday, February 09, 2015 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)) 02/02/15 738964 $15.00 I hereby certify that the attached invoice(s), or bill(s), is(are)true and correct and I have audited same in accordance- with ccordancewith IC 5-11-10-1.6 , 20 Clerk-Treasurer Indiana University Health Workplace Services,LLC 950 North Meridian Street it�s Suite 950 (City of Carmel) l(� Indianapolis, IN 46204 12os Phone: 317-963-1535 FEIN: 20-0994452 Invoice February 02, 2015 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite EAP Services/Jan.2015 1 Civic Square Carmel,IN 46032- Invoice# 739436 Proc Code Date Description City Charge Recei Ad'us Balance EAPSERV 01/01/2015 EAP Services 577.00 692.40 692.40 577 Employees Balance Due: 692.40 Invoice# 739436 Balance Due: 692.40 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK Submitted To FEB 0 9'2014 Clerk Treasurer ___ Cut and tetum with payment VOUCHER NO. WARRANT NO. IU Health Workplace Services, LLC ALLOWED 20 IN SUM OF$ 2046 Reliable Pkwy Chicago, IL 60686-0020 $692.40 ON ACCOUNT OF APPROPRIATION FOR Administration Department PO#/Dept. INVOICE NO. ACCT#IrITLE AMOUNT Board Members 1205 I 739436 I 43-475.00 I $692.40 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, February 09, 2015 Director, Administration Title Cost distribution ledger classification if claim paid motor vehicle highway fund 1 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)) 02/02/15 739436 $692.40 hereby certify that the attached invoice(s),or bill(s), is(are)true and correct and I have audited same in accordance ith IC 5-11-10-1.6 20 Clerk-Treasurer Indiana University Health Workplace Services,LLC 950 North Meridian Street Suite 950 Indianapolis, IN 46204 Phone: 317-963-1535 FEIN: 20-0994452 Invoice February 02, 2015 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Onsite Fees/Jan.2015 1 Civic Square Carmel, IN 46032- Invoice# 739437 Proc Code Dae Description C Charge . Rec i Adu—sl Balance CARMBUIL 01/01/2015 City of Carmel Clinic Build Out 1.00 2574.16 2574.16 CARMLEAS 01/01/2015 City of Carmel Sports Performance 1.00 1800.00 1800.00 Lease Balance Due: 4374.16 Invoice# 739437 Balance Due: 4374.16 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK Submitted To FEB 0 9 2014 Clerk Treasurer 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 February 02, 2015 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Misc.Onsite/Jan.2015 1 Civic Square Carmel,IN 46032- Invoice# 739448 Proc Code Date Description Cly Charge Recelp Ad'us Balance 99070 11/30/2014 Young at Heart Clinic Meds 1.00 251.06 251.06 99070 12/21/2014 Young at Heart Clinic Meds 1.00 1157.52 1157.52 99070 12/28/2014 Young at Heart Mail-Ins 1.00 12599.47 12599.47 99070 12/31/2014 Onsite Lab Charges 1.00 1656.85 1656.85 December 2014 X Labs 99070 12/31/2014 Young at Heart Clinic Meds 1.00 563.63 563.63 99070 01/11/2015 Young at Heart Clinic Meds 1.00 120.32 120.32 Balance Due: 16348.85 Invoice# 739448 Balance Due: 16348.85 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK Submitted To FEB 0 9'2014 Clerk Treasurer Cut and return with payment —� -------------------------------------------------------------------------------------— Indiana University Health Workplace Services,LLC `tel 950 North Meridian Street Suite 950 (City of Carmel) Indianapolis, IN 46204 Phone: 317-963-1535 FEIN: 20-0994452 Invoice February 02, 2015 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Supply Billing/Jan. 2015 1 Civic Square Carmel,IN 46032- Invoice# 739584 Proc Code Date Description otyt Charge Recei Adjust Balance 99070 01/01/2015 Onsite Operating Supplies 1.00 .1293.86 1293.86 January 2015 Supplies Balance Due:.. 1293.86 Invoice#,739584 Balance Due: 1293.86 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 (City of Carmel) Indianapolis, IN 46204 Phone: 317-963-1535 FEIN: 20-0994452 Invoice February 02, 2015 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Staff Time/Jan. 2015 1 Civic Square Carmel,IN 46032- Invoice# 739288 Proc Code Date Description -Qty Charge Recei Adju-sj Balance NURSEMA 01/02/2015 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride NURSEMD 01/02/2015 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 01/02/2015 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 01/05/2015 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride NURSEMD 01/05/2015 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 01/05/2015 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 01/06/2015 M.A.Staff Time 6.00 168.00 168.00 Kimberly Pride NURSEMD 01/06/2015 MD Staff Time 6.00 1050.00 1050.00 Dr.Fagan NURSERN 01/06/2015 R.N.Staff Time 6.00 372.00 372.00 Mareesa Martin NURSEMA 01/07/2015 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride NURSEMD 01/07/2015 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 01/07/2015 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 01/08/2015 M.A.Staff Time 4.00 112.00 112.00 Kimberly Pride NURSEMD 01/08/2015 MD Staff Time 4.00 700.00 700.00 Dr.Fagan NURSERN 01/08/2015 R.N.Staff Time 4.00 248.00 248.00 Mareesa Martin NURSEMA 01/09/2015 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride NURSEMD 01/09/2015 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 01/09/2015 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 01/12/2015 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride Invoice# 739288 (continued)page 2 NURSEMD 01/12/2015 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 01/12/2015 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 01/13/2015 M.A.Staff Time 6.00 168.00 168.00 Kimberly Pride NURSEMD 01/13/2015 MD Staff Time 6.00 1050.00 1050.00 Dr.Fagan NURSERN 01/13/2015 R.N.Staff Time 6.00 372.00 372.00 Mareesa Martin NURSEMA 01/14/2015 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride NURSEMD 01/14/2015 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 01/14/2015 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 01/15/2015 M.A.Staff Time 4.00 112.00 112.00 Kimberly Pride NURSEMD 01/15/2015 MD Staff Time 4.00 700.00 700.00 Dr.Fagan NURSERN 01/15/2015 R.N.Staff Time 4.00 248.00 248.00 Mareesa Martin NURSEMA 01/16/2015 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride NURSEMD 01/16/2015 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 01/16/2015 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 01/19/2015 M.A.Staff Time 3.00 84.00 84.00 Kimberly Pride NURSERN 01/19/2015 R.N.Staff Time 3.00 186.00 186.00 Mareesa Martin NURSEMA 01/20/2015 M.A.Staff Time 6.00 168.00 = 168.00 Kimberly Pride NURSEMD 01/20/2015 MD Staff Time 6.00 1050.00 1050.00 Dr.Fagan NURSERN 01/20/2015 R.N.Staff Time 6.00 372.00 372.00 Mareesa Martin NURSEMA 01/21/2015 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride NURSEMD 01/21/2015 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 01/21/2015 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 01/22/2015 M.A.Staff Time 4.00 112.00 112.00 Kimberly Pride NURSEMD 01/22/2015 MD Staff Time 4.00 700.00 700.00 Dr.Fagan NURSERN 01/22/2015 R.N.Staff Time 4.00 248.00 248.00 Mareesa Martin NURSEMA 01/23/2015 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride NURSEMD 01/23/2015 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 01/23/2015 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 01/26/2015 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride Invoice# 739288 (continued)page 3 NURSEMD 01/26/2015 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 01/26/2015 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 01/27/2015 M.A.Staff Time 6.00 168.00 168.00 Kimberly Pride - NURSEMD 01/27/2015 MD Staff Time 6.00 1050.00 1050.00 Dr.Fagan NURSERN 01/27/2015 R.N.Staff Time 6.00 372.00 372.00 Mareesa Martin NURSEMA 01/28/2015 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride NURSEMD 01/28/2015 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 01/28/2015 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin NURSEMA 01/29/2015 M.A.Staff Time 4.00 112.00 112.00 Kimberly Pride NURSEMD 01/29/2015 MD Staff Time 4.00 700.00 700.00 Dr.Fagan NURSERN 01/29/2015 R.N.Staff Time 4.00 248.00 248.00 Mareesa Martin NURSEMA 01/30/2015 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride NURSEMD 01/30/2015 MD Staff Time 5.00 875.00 875.00 Dr.Fagan NURSERN 01/30/2015 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin Balance Due: 26770.00 Invoice# 739288 Balance Due: 26770.00 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK Submitted To FEB 09 814 Clark Treasurer _ Cut and return with payment Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Forrn 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)) 02/02115 739437 Fees!jan 2015- 374.16 02/02/15 739448 M'se ns*te/jan20l5 85 02102/15 739584 WW1dF.yF Billing/jan 2015 02/02/15 739288 E)nsite Staff Tome/jan 2016 26-770.00 48,786. 7 Total 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 MM9/15 WARRANT NO. ALLOWED 20 IU Health Workplace Services, LLC IN SUM OF $ 2046 Reliable Pkwy Chicago, IL 60686-0020 4§,786.87 ON ACCOUNT OF APPROPRIATION FOR i 301 Medical Fund Board Members PO#or INVOICE NO. ACCT#/TITLE AMOUNT DEPT.# I hereby certify that the attached invoice(s), j or bill(s) is (are) true and correct and that 1 the materials or services itemized thereon 7394374 for which charge is made were ordered and 7394484 48 I received except I l MAU 11^4 I ✓ 20 r / Signa ure Title Cost distribution ledger classification if claim paid motor vehicle highway fund