The URL can be used to link to this page

242989 03/11/15 y��..4�xM CITY OF CARMEL, INDIANA VENDOR: 367222 ® ONE CIVIC SQUARE IU HEALTH WORKPLACE SERVICES LLCCHECK AMOUNT: $****45,645.46* :. ;� CARMEL, INDIANA 46032 2046 RELIABLE PKWY CHECK NUMBER: 242989 9�jh'UNLp'`9 CHICAGO IL 60686-0020 CHECK DATE: 03/11/15 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 301 5023990 739796 4,374.16 OTHER EXPENSES 301 5023990 739850 26,500.00 OTHER EXPENSES 1201 4358800 740186 30.00 TESTING FEES 1205 4347500 740295 692.40 GENERAL INSURANCE 301 5023990 740322 524.42 OTHER EXPENSES 301 5023990 740323 13,524.48 OTHER EXPENSES `5 Indiana University Health Workplace Services,LLC 950 North Meridian Street Suite 950 (City of Carmel) Indianapolis, IN 46204 317-963-1535 Tax ID# 20-0994452 Invoice February 28, 2015 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Onsite/Feb.2015 1 Civic Square Carmel,IN 46032- Invoice# 740186 Service Date Description Quanti Charae Receip 'Ad'us Balance 02/25/2015 Quick Read UDS/6panel includes 1.00 15.00 15.00 kit Fb10 Cut andrcturn with ng--# r VOUCHER NO. WARRANT NO. ALLOWED 20 IU Health Workplace Services, LLC IN SUM OF$ 2046..Reliable Pkwy Chicago, IL 60686-0020 $30.00 ON ACCOUNT OF APPROPRIATION FOR Carmel HR Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1201. I 740186 I 43-588.00 I $30.00 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, March 09, 2015 Director, HR i Title Cost distribution ledger classification if j claim paid motor vehicle highway fund I 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)) 02/28/15 740186 Testing $30.00 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 3 950 North Meridian Street Suite 950 Indianapolis, IN 46204 317-963-1535 Tax ID# 20-0994452 Invoice February 28, 2015 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Onsite Fees/Feb.2015 1 Civic Square Carmel,IN 46032- __ _.a.__.---.__._.___....__. .. Invoice# 739796 Service Date Description Quantit Charge Recelp Adjust Balance 02/01/2015 City of Carmel Sports Performance 1.00 1,800.00 1800.00 Lease 02/01/2015 City of Carmel Clinic Build Out 1.00 2,574.16 2574.16 CITYCARO Invoice# 739796 Balance Due: 4374.16 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK Submitted To MAR 0 9 2015 Clerk.. Treasurer Cut and return with payment Indiana University Health Workplace Services,LLC v 950 North Meridian Street Suite 950 (City of Carmel) Indianapolis, IN 46204 317-963-1535 Tax I D# 20-0994452 Invoice February 28, 2015 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Misc.Onsite/Feb.2015 1 Civic Square Carmel,IN 46032- ._. Invoice# 740323 Service Date Description Quantit Charae Recei t Adjust Balance 01/01/2015 Onsite Lab Charges 1.00 2,242.18 2242.18 January 2015 Labs 01/11/2015 Young at Heart Mail-Ins 1.00 3,441.28 3441.28 01/16/2015 Young at Heart Clinic Meds 1.00 1,134.65 1134.65 01/18/2015 Young at Heart Mail-Ins 1.00 1,263.77 1263.77 01/25/2015 Young at Heart Mail-Ins 1.00 1,806.74 1806.74 01/31/2015 Young at Heart Mail-Ins 1.00 1,870.76 1870.76 02/02/2015 Young at Heart Clinic Meds 1.00 1,113.54 1113.54 02/08/2015 Young at Heart Mail-Ins 1.00 651.56 651.56 CITYCARO Invoice# 740323 Balance Due: 13524.48 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK MAR 0-9 2015 Clare �-Leasure ' Cut and return with payment Indiana University Health Workplace Services, LLC v 1 950 North Meridian Street Suite 950 (City of Carmel) Indianapolis, IN 46204 317-963-1535 Tax ID# 20-0994452 Invoice February 28, 2015 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Supply Billing/Feb.2015 1 Civic Square Carmel,IN 46032- Invoice# 740322 Service Date Description Quantit Charoe Recei Aau-sl Balance 02/01/2015 Onsite Operating Supplies 1.00 524.42 524.42 February 2015 Supplies CITYCARO Invoice# 740322 Balance Due: 524.42 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK Submitted To MAR 0 9 2015 Clare Treasurer Cut and return with payment �) Indiana University Health Workplace Services, LLC 950 North Meridian Street Suite 950 (City of Carmel) Indianapolis, IN 46204 317-963-1535 Tax ID# 20-0994452 Invoice February 28, 2015 Bill to: Barbara Lamb For: Ci of Carmel City -Onsite City of Carmel-Onsite Staff Time/Feb.2015 1 Civic Square Carmel,IN 46032- Invoice# 739850 Service Date Description Quanti Charae Receipt Adjust Balance 02/02/2015 MD Staff Time 5.00 875.00 875.00 Dr.Fagan 02/02/2015 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin 02/02/2015 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride 02/03/2015 MD Staff Time 6.00 1,050.00 1050.00 Dr.Fagan 02/03/2015 R.N.Staff Time 6.00 372.00 372.00 Mareesa Martin 02/03/2015 M.A.Staff Time 6.00 168.00 168.00 Kimberly Pride 02/04/2015 MD Staff Time 5.00 875.00 875.00 Dr.Fagan 02/04/2015 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin 02/04/2015 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride 02/05/2015 MD Staff Time 4.00 700.00 700.00 Dr.Fagan 02/05/2015 R.N.Staff Time 4.00 248.00 248.00 Mareesa Martin 02/05/2015 M.A.Staff Time 4.00 112.00 112.00 Kimberly Pride 02/06/2015 MD Staff Time 5.00 875.00 875.00 Dr.Fagan 02/06/2015 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin 02/06/2015 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride 02/09/2015 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin Suby�,-nftted To MAR 0 92015 Clerk Treasurer Invoice# 739850(continued)page 2 Service Date Description Quantit Charge Recei t Adjust Balance 02/09/2015 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride 02/09/2015 MD Staff Time 5.00 875.00 875.00 Dr.Fagan 02/10/2015 R.N.Staff Time 6.00 372.00 372.00 Mareesa Martin 02/10/2015 M.A.Staff Time 6.00 168.00 168.00 Kimberly Pride 02/10/2015 MD Staff Time 6.00 1,050.00 1050.00 Dr.Sunderman 02/11/2015 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin 02/11/2015 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride 02/11/2015 MD Staff Time 5.00 875.00 875.00 Dr.Fagan 02/12/2015 R.N.Staff Time 4.00 248.00 248.00 Mareesa Martin 02/12/2015 M.A.Staff Time 4.00 112.00 112.00 Kimberly Pride 02/12/2015 MD Staff Time 4.00 700.00 700.00 Dr.Fagan 02/13/2015 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin 02/13/2015 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride 02/13/2015 MD Staff Time 5.00 875.00 875.00 Dr.Fagan 02/16/2015 MD Staff Time 5.00 875.00 875.00 Dr.Fagan 02/16/2015 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin 02/16/2015 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride 02/17/2015 MD Staff Time 6.00 1,050.00 1050.00 Dr.Fagan 02/17/2015 R.N.Staff Time 6.00 372.00 372.00 Mareesa Martin 02/17/2015 M.A.Staff Time 6.00 168.00 168.00 Kimberly Pride 02/18/2015 MD Staff Time 5.00 875.00 875.00 Dr.Fagan 02/18/2015 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin 02/18/2015 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride 02/19/2015 MD Staff Time 4.00 700.00 700.00 Dr.Fagan Invoice# 739850(continued)page 3 Service Date Description Quanti Charge Receipt Adjust Balance 02/19/2015 R.N.Staff Time 4.00 248.00 248.00 Mareesa Martin 02/19/2015 M.A.Staff Time 4.00 112.00 112.00 Kimberly Pride 02/20/2015 MD Staff Time 5.00 875.00 875.00 Dr.Fagan 02/20/2015 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin 02/20/2015 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride 02/23/2015 MD Staff Time 5.00 875.00 875.00 Dr.Fagan 02/23/2015 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin 02/23/2015 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride 02/24/2015 MD Staff Time 6.00 1,050.00 1050.00 Dr.Fagan 02/24/2015 R.N.Staff Time 6.00 372.00 372.00 Mareesa Martin 02/24/2015 M.A.Staff Time 6.00 168.00 168.00 Kimberly Pride 02/25/2015 MD Staff Time 5.00 875.00 875.00 Dr.Fagan 02/25/2015 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin 02/25/2015 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride 02/26/2015 MD Staff Time 4.00 700.00 700.00 Dr.Fagan 02/26/2015 R.N.Staff Time 4.00 248.00 248.00 Mareesa Martin 02/26/2015 M.A.Staff Time 4.00 112.00 112.00 Kimberly Pride 02/27/2015 MD Staff Time 5.00 875.00 875.00 Dr.Fagan 02/27/2015 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin 02/27/2015 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride CITYCARO Invoice# 739850 Balance Due: 26500.00 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK va Cut and return with payment Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No.201(Rev.199 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 02/28/15 739796 /Feb 2015 13,524.48 02/28/15 40 /Feb 2015 524.42 02/28/15 7403 26,500.00 02/28/15 739850 0mite Staff Timei Feb 2015 44 923.06 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 NO.03/09/15 WARRANT NO. IU Health Workplace Services, LLC ALLOWED 20 IN SUM OF $ 2046 Reliable Pkwy i Chicago, IL 60686-0020 $ 44,923.06 ON ACCOUNT OF APPROPRIATION FOR 301 Medical Fund Board Members 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 739796 301 14,374.16 for which charge is made were ordered and 740323 3nj received except 740322 2j)j $924.42 i ,I 20 Signature Cost distribution ledger classification if Title claim paid motor vehicle highway fund ''11 Indiana University Health Workplace Services,LLC `I 950 North Meridian Street Suite 950 (City of Carmel) 1 2cis Indianapolis, IN 46204 317-963-1535 Tax ID# 20-0994452 Invoice February 28, 2015 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite EAP Services/Feb.2015 1 Civic Square Carmel,IN 46032- _._.___..__..._...__- Invoice# 740295 Service Date Description Quanti Care Recein Adjust Balance 02/01/2015 EAP Services 577.00 692.40 692.40 577 Employees CITYCARO Invoice# 740295 Balance Due: 692.40 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK Su bm—Itted To MAR 0 9 2015 Clerk 'Treasurer and return with payment 'VOUCHEkNO. WARRANT NO. ALLOWED 20 IU Health Workplace Services, LLC IN SUM OF$ 2046 Reliable.Pkwy Chicago, IL 60686-0020 $692.40 ON ACCOUNT OF APPROPRIATION FOR Administration Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1205 I 740295 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, March 09, 2015 Director,Administration Title I 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)) 02/28/15 740295 EAP Services $692.40 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