HomeMy WebLinkAbout255863 03/01/16 y u%.4Qgy
^/ CITY OF CARMEL, INDIANA VENDOR: 367222
�l ONE CIVIC SQUARE IU HEALTH WORKPLACE SERVICES LLCCHECK AMOUNT: $"•'47,504.74•
9 ,�a. CARMEL, INDIANA 46032 2046 RELIABLE PKWY CHECK NUMBER: 255863
�'��TON�°. CHICAGO IL 60686-0020 CHECK DATE: 03/01/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1201 4358800 747018 112.00 TESTING FEES
301 5023990 747068 27,329.00 OTHER EXPENSES
301 5023990 747069 4,374.16 OTHER EXPENSES
1205 4347500 747187 711.60 GENERAL INSURANCE
301 5023990 747190 13,412.36 OTHER EXPENSES
301 5023990 747432 1,565.62 OTHER EXPENSES
Indiana University Health Workplace Sewices, LLC
950 North Meridian Street -33)
Suite 950 (City of Carmel).
Indianapolis, IN 46204
317-963-1535
Tax ID# 20-0994452
Invoice
January 31, 201.6
Bill to: Barbara Lamb For: City of Carmel-Onsite
City of Carmel-Onsite Staff Time/Jan.201.6
1 Civic Square
Carmel,IN 46032-
Invoice# 747068
Service Date Description Quanti Charge . Receiot Aju§t Balance
01/04/2016. R.N.Staff Time 5.00. 310:00 310.00
Mareesa Martin
01/04/2016 M.A.Staff Time ' 6.00 168:00 168.00
Kimberly Pride
01/04/2016 MD Staff Time 5.00 875:00. 875.00
Dr.Fagan
01/05/2016 R.N.Staff Time 6.50 403.00 403.00
Mareesa Martin .
01/05/2016 M.A.Staff Time 6.50 182:00 182.00
Kimbet•ly Pride
01/05/2016 MD Staff Time 6.00 1,050.00 1050.00
Dr.Fagan
01/06/2016 R.N.Staff Time 6.00 372.00 372.00
Mareesa Martin .
01/06/2016 M.A.Staff Time 7.00 196:00 196.00
Kimberly Pride
01/06/2016 MD Staff Time 5.00 875:00 875.00
Dr.Fagan
01/07/2016 R.N.Staff Time 4.50 279.00 279.00
Mareesa Martin .
01/07/2016 M.A.Staff Time 5.00 . 140.00 140.00
Kimberly Pride
01/07/2016 MD Staff Time 4.00 700.00 700.00
Dr.Fagan
61/08/2016 R.N.Staff Time 6.50 '403 00 403.00
Mareesa Martin
01/08/2016 M.A.Staff Time' 7.00 196.00 196.00
Kimberly Pride
01/08/2016 MD Staff Time 5.00 875.00 875.00
Dr.Fagan
01/11/2016 R.N.Staff Time 5.75 356.50 356.50
Mareesa Martin
Submitted To
FEB 0 S 2016
Clerk Treasurer
Invoice# 747068(continued)page 2
Service Date Description Quantity Chews Receipt Adjust Balance
01/11/2016 M.A.Staff Time 5.25 147.00 147.00
Kimberly Pride
01/11/2016 MD Staff Time 5.00 875.00 875.00
Dr.Fagan
01/12/2016 R.N.Staff Time 7.25 449:50 449.50
Mareesa Marlin
01/12/2016 M.A.Staff Time 6.00 .168.00 168.00
.Kimberly Pride
.01/12/2016 MD Staff Time . 6.00 1,050.00 1050.00
Dr.Fagan
01/13/2016 R.N.Staff Time 6.00 372.00. 372.00
Mareesa Martin
01/13/2016 M.A.Staff Time 6.50 182.00 182.00
Kimberly Pride
01/13/2016 MD Staff Time 5.00 875.00 875.00
Dr.Fagan
01/14/2016 R.N.Staff Time 5.00 310.00.-. 310.00
Mareesa Mai-tin
01/14/2016' M.A.Staff Time 5.50 154.00 154.00
Kimberly Pride ..
01/14/2016 MD Staff Time 4.00 700.00 700.00
Dr.Fagan
01/15/2016 R.N.Staff Time 5.75 356.50. 356.50
Mareesa Marlin
01/15/2016 M.A.Staff Time 6.00 168.00 168.00
Kimberly Pride
01/15/2016 MD Staff Time 5.00 875.00 875.00
Dr.Fagan
01/18/2016 R.N.Staff Time 5.00 310.00 310.00.
Mareesa Martin
01/18/2016 M.A.Staff Time 5.50 154.00 154.00
Kimberly Pride
01/19/2016 MD Staff Time 6.00 1,050.00 1050.00
Dr.Fagan
01/19/2016 R.N.Staff Time 6.75 418.50 418.50
Mareesa Martin
01/19/2016 M.A.Staff Time 7.00 196.00 196.00
Kimberly Pride
01/20/2016 MD Staff Time 5.00 875.00 875.00
Dr.Fagan
01/20/20,16- R.N.Staff Time '. . 6.50. 403.00. 403.00:
Mareesa Martin
01/20/2016 M.A.Staff Time 7.25 203.00 203.00
Kimberly Pride
01/21/2016 MD Staff Time 4.00 700.00 700.00
Dr.Fagan
01/21/2016 R.N.Staff Time 5.00 310.00 310.00
Mareesa Martin
3rescribed by State Board of Accounts City Form No.201(Rev.1995)
ACCOUNTS PAYABLE VOUCHER
.CITY. OF CARMEL
4n 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 Date Invoice# Description Amount
Dept. Fund# (or note attached.invoice(s)or bill(s))
01/31/16 -.747068 Onsite-Staff Time Jan $27,329.00 .
301 301
01/31/16 747069 'Onsite Fees:Jan $4,374.16
-301 301
01/31/16 747432 Oniste Supply Billing Jan $1,565.62
301 301
01/31/16 747190 Onsite Misc Jan $13,412.36
301 301
I hereby certify that the attached invoice(s), or.bill(s), is:(are)ArUe'and correct and I have audited same in accordance
with IC 5-11-10-1.6 .
20
Clerk-Treasurer
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 Date Invoice# Description Amount
Dept. Fund# (or note attached i6voice(s)or bill(s))
01/31/16 747187 EAP Services $711.60
1205 101
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
1 Indiana Oniversity Health Workplace Services, LLC
950 North Meridian Street
;5 Suite 950 (City of Carmel)
Indianapolis, IN 46204 .
317-963-1535
Tax ID#'20-0994452
Invoice
January 31, 2016 .
Bill to: Barbara Lamb For: City of Carmel Onsite
City of Carmel-Onsite' EAP Services/Jan.2016
1 Civic Square
Carmel,IN 46032-
Invoice# 747187
Service Date Description: Quant! Chase •Receipt . Adjust_ . Balance
'01/01/2016 _ EAP Services 593.00 711:60 711.60
CITYCARO Invoice#. 747187 Balance Due: 711.60
MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE
INVOICE#ON CHECK
Submirtf,,d T '
FEB 08 2016
Clerk `treasurer .
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 Date Invoice# Description Amount
Dept. Fund# (or note attached invoice(s)or bill(s))
01/31/16 I 747018 I Onsite Drug Screens Jan I $112.00
1201 101
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, LLCM
950 North Meridian Street
Suite 950 (City of Carmel)
Indianapolis,.IN 46204:
317-963-1535
Tax ID# 20-0994452 . . .
Invoice
January 31, 201:6 .
Bill to: Barbara Lamb For: . City of Carmel-Onsite
City of Carmel-Onsite Onsite/Drug Screens/Jan.
1 Civic Square
Carmel,IN 46032-
Invoice# 747018
Service Date Description. Quanti Charge Receipt . Adiust Balance
01/20/2016 Quick Read UDS/
Due: 15.00
Submitted To
FEB 0 8 2016
Clerk Treasurer
Invoice# 747018(continued)page 2
Service Date Description Quanti Cha�de Receipt Ad'us Balance
01/14/2016 Quick Read UDS/6panel includes 1.00 15.00 15.00
kit
15.00,
CITYCARO Invoice#. 747018 Balance Due: 112.00
MAKE PAYMENT.TO THE BELOW ADDRESS.WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE. .
INVOICE#ON CHECK .