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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 .