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Home My WebLink About256392 03/15/16 a`� 'Esq CITY OF CARMEL, INDIANA VENDOR: 367222 :,• ONE CIVIC SQUARE IU HEALTH WORKPLACE SERVICES LLCCHECK AMOUNT: $****46,404.74* r. ra CARMEL, INDIANA 46032 2046 RELIABLE PKWY CHECK NUMBER: 256392 'M,�ioN� CHICAGO IL 60686-0020 CHECK DATE: 03/15/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 301 5023990 747640 4,374.16 OTHER EXPENSES 301 5023990 747641 32,822.00 OTHER EXPENSES 1201 4358800 747741 45.00 TESTING FEES 1205 4347500 747894 732.00 GENERAL INSURANCE 1110 4340701 748055 150.00 MEDICAL EXAM FEES 301 5023990 748055 7,163.74 OTHER EXPENSES 301 5023990 748123 1,117.84 OTHER EXPENSES VOUCHER NO. WARRANT NO. ALLOWED 20 IU HEALTH WORKPLACE SERVICES LLC 2046 RELIABLE PKWY IN SUM OF$ CHICAGO, IL 60686-0020 $732.00 ON ACCOUNT OF APPROPRIATION FOR -General Administration PO#/Dept. INVOICE NO. ACCT#/Fund AMOUNT Board Members 747894 43-475.00 $732.00 1 hereby certify that the attached invoice(s), or 1205 101 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 Wednesday, March 02, 2016 .Cost distribution ledger classification if_ claim paid motor vehicle highway fund 'rescribed by State Board of Accounts City Form No.201(Rev.1995) ACCOUNTS PAYABLE VOUCHER .CITY OF CARMEL Nn invoice or bill to be properly itemized must show: kind of service,where performed,dates service rendered, by vhom, rates per day, number of hours, rate per hour, number of units, price per unit,etc. Payee -Purchase Order No. Terms Date Due nvoice Date Invoice# DescriptionAmount Dept. Fund# (or note attachedinvoice(s)'or bill(s)) 03/02/16 -747894 EAP Services Feb,2016 $732.00 1205 101 I hereby certify that the attached invoice(s), or bill(s), is(are)true and correct and I:have audited"same in-accordance with IC 5-11-10-1.6 , 20 Clerk-Treasurer Indiana University Health Workplace Services,LLC '-l2s 950 North Meridian Street Suite 950 (City of Carmel) Indianapolis,, IN 46204 317-9637-1535 Tax ID# 20-0994452 Invoice February 29, 2016 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite EAP Services/Feb.2016 1 Civic Square Carmel,IN 46032- �_�~� Invoice# 747894 Service Date Description Quanti Charge Recei Adjust Balance 02/01/2016 EAP Services 610.00 732.00 732.00 CITYCARO Invoice# 747894 Balance Due: .732.00 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK Submitted To MAR 0�2016 „� Cut and rctum with payment VOUCHER NO. WARRANT NO. ALLOWED 20 IU HEALTH WORKPLACE SERVICES LLC 2046 RELIABLE PKWY IN SUM OF$ CHICAGO, IL-60686-0020 - $45.00 ON ACCOUNT OF APPROPRIATION FOR Human Resources PO#/Dept. INVOICE NO. ACCT#/Fund AMOUNT Board Members 747741 I 43-588.00 I $45.00 1 hereby certify that the attached invoice(s), or 1201 101 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 Wednesday, March 02, 2016 .,.Cost distribution.ledger.classification if claim paid motor vehicle highway fund rescribed.by State Board of Accounts. City Form No.201(Rev.1995) ACCOUNTS PAYABLE. VOUCHER CITY OF.CARMEL �n invoice or bill to be properly itemized must show: kind of service,where-performed, dates service rendered,by vhom, rates per day, number-of hours, rate per hour, number of units,price per unit,etc. Payee Purchase Order No. Terms Date Due nvoice Date Invoice# Description Amount Deft. Fund#:. (or note,attached-invoice(s)or.bill(s)) 03/02/16 747741 Onsite Drug Screens Feb 2016 $45.00 1201 I 101 I I hereby certify that the attached invoice(s), or bill(s), is(are)true and correct and 1,have audited same in accordance with IC 5-11-10-1.6 , 20- Clerk-Treasurer 20Clerk-Treasurer Indiana University Health Workplace Services, LLC s 950 North Meridian Street Suite 950 (City of Carmel) Indianapolis, IN 46204 317-963-1535 Tax ID# 20-0994452 Invoice February 29, 2016 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Onsite/Drug Screens/Feb. 1 Civic Square Carmel,IN 46032- - Invoice# 747741 Service Date Description Quanti Charae Recei Agust Balance 02/18/2016 Quick Read UDS/6panel includes 1.00 15.00 15.00 kit 45.00 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK Submitted, To MAR 0�2016 Clerk Treasurer w Cut and return with payment VOUCHER NO. WARRANT NO. ALLOWED 20 IU HEALTH WORKPLACE SERVICES LLC 2046 RELIABLE PKWY - IN SUM OF$ CHICAGO, IL 60686-0020 ON ACCOUNT OF APPROPRIATION FOR 301 Medical Fund PO#/Dept. INVOICE NO. ACCT#/Fund AMOUNT Board Members 747640 110-100.00 $4,374.16 1 hereby certify that the attached invoice(s), or 301 301 NO ' 7eb J ��B_�� j �� bill(s) is (are)true and correct and that the '748055 110-100.00 $7,163.74 materials or services itemized thereon for 301 301 which charge is made were ordered and 748123 110-100.00 $1,117.84 301 301 received except 747641 110-100.00 $32,822.00 301 301 Wednesday, March 02, 2016 Cost distribution ledger.classification if claim paid motor vehicle highway fund 'escribed by State Board of Accounts City Form No.201(Rev.1995) ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL n invoice or bill to be properly itemized must show: kind of service,where performed,dates service rendered, by ,hom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee Purchase Order No. Terms Date Due tvoice Date Invoice# Description Amount Dept. Fund# (or note attached invoice(s)or bill(s)) 03/02/16 747640 Onsite Fees Feb 2016 $4,374.16 301 301 03/02/16 Misc Onsite Feb 2016rPolice,�70'01. J �� DO 03/02/16 748055 Onsite Misc Feb 2016 HR $7,163.74, 301 301 03/02/16 748123. Onsite Supply Billing Feb 2016 $1,117.84 301 301 03/02/16 747641 Onsite Staff Time Feb 2016 $32,822.00 301 301 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 950 North Meridian Street Suite 950 (City of Carmel) Indianapolis, IN 46204 317-963-1535 Tax ID# 20-0994452 Invoice February 29, 2016 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Misc.Onsite/Feb.2016 1 Civic Square Carmel,IN 46032- _ Invoice# 748055 Service Date DescriptionQuant! Charge Receipt Adjust Balance 01/11/2016 Young at Heart Clinic Meds 1.00 473:32 473.32 01/24/2016 Young at Heart Mail-Ins 1.00 597.41 597.41 01/31/2016 Onsite Lab Charges 1.00 3,750.84 3750.84 Jan.2016 Labs 02/02/2016 Young at Heart Clinic Meds 1.00 1,789.31 1789.31 02/03/2016 CITYCARO Invoice# 748055 Balance Due: 7313.74 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK M Subwj.1.1:4-d To Z MAR 07,2016 Clerk w' e sLirer Cnt and rehim with navment Indiana University Health Workplace Services;LLC 950 North Meridian Street Suite 950 (City of Carmel) Indianapolis, IN 46204 317-963-1535 Tax ID# 2070994452 Invoice February 29, 2016 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Supply Billing/Feb.2016 1 Civic Square Carmel,IN 46032- ! _ Invoice# 748123 Service Date Description Quanti Charge Recei t Adjust Balance 02/01/2016 Onsite Operating Supplies 1.00 1,117.84 1117.84 February 2016 Supplies CITYCARO Invoice# 748123 Balance Due: 1117.84 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE.#ON CHECK Submitted To MAR 4 � 2016 Clerk Treasurer Cut and return with payment Indiana University Health Workplace Services, LLC 950 North Meridian Street 1 Suite 950 Indianapolis, IN 46204 317-963-1535 Tax ID# 20-0994452 Invoice February29, 2016 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Onsite Fee's/F.6.2016 1 Civic Square Carmel,IN 46032- . — Invoice# 747640 . Service Date Description Quanti ,Charge Recelp Adjust Balance 02/01/2016 City of Cannel Sports Performance 1.00- 11800.00 1800.00. Lease 02/01/2016 City of Cannel Clinic Build Out 1.00 2,574.16 2574.16 CITYCARO Invoice# 747640 Balance Due: 4374.16 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK Submitted To' MAR -012016 Clerk T g sssurer Cut and return with payment Invoice# 747641 (continued)page 4 Service Date Description Quantity Charge Recei 1 Adiust Balance 02/26/2016 MD Staff Time 5.00 875.00 875.00 Dr.Fagan . 02/26/2016 M.A.Staff Time 6.50 182.00 182.00 Kimberly Pride 02/29/201.6 R.N.Staff Time 6.25 387.50 387.50. - Mareesa Martin 02/29/2016 Health Coach Staff Time 3.00 192.00 192.00 Marissa Grant 02/29/2016 MD Staff Time 5.00 875.00 875.00. Dr.Fagan: 02/29/2016 M.A.Staff Time 6.75 189.00 189.00 Kimberly Pride CITYCARO Invoice# 747641 Balance Due: 32822.00 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK i Invoice# 747641 (continued)page 3 Service Date Description Quanti Charge Receioi Ad ust Balance 02/18/2016 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin 02/18/2016 Health Coach Staff Time 4.50 288.00 288.00 Marissa Grant 02/18/2016 MD Staff Time 4.00 700.00 700.00 Dr.Fagan 02/18/2016 M.A.Staff Time 7.75 217.00 217.00 Kimberly Pride 02/19/2016 R.N.Staff Time 5.50 341.00 341.00 Mareesa Martin 02/19/2016 Health Coach Staff Time 4.50 288.00 288.00 Marissa Grant 02/19/2016 MD Staff Time 5.00 875.00 875.00 Dr.Fagan 02/19/2016 M.A.Staff Time 8.00 224.00 224.00 \ Kimberly Pride 02/22/2016 R.N.Staff Time 6.25 387.50 . 387.50 Mareesa Martin 02/22/2016 Health Coach Staff Time 3.00 192.00 192.00 Marissa Grant 02/22/2016 MD Staff Time 5.00 875.00 875.00 Dr.Fagan 02/22/2016 M.A.Staff Time 6.50 182.00., 182.00 Kimberly Pride 02/23/2016 R.N.Staff Time 7.00 434.00: 434.00 Mareesa Martin 02/23/2016 MD Staff Time 6.00 1,050.00 1050.00 Dr.Fagan 02/23/2016 M.A.Staff Time 6.75 189.00;`. 189.00 Kimberly Pride 02/24/2016 R.N.Staff Time 6.00 372.00 372.00 Mareesa Martin 02/24/2016 MD Staff Time 5.00 875.00 875.00 Dr.Fagan 02/24/2016 M.A.Staff Time 7.00 196.00 196.00 Kimberly Pride 02/25/2016 R.N.Staff Time 6.25 387.50• 387.50 Mareesa Martin 02/25/2016 Health Coach Staff Time 4.50 288.00 288.00 Marissa Grant 02/25/2016 MD Staff Time 4.00 700.00 700.00 Dr.Fagan 02/25/2016 M.A.Staff Time 6.00 168.00' 168.00 Kimberly Pride 02/26/2016 R.N.Staff Time 7.25 449.50 449.50 Mareesa Martin 02/26/2016 Health Coach Staff Time 4.50 288.00 288.00 Marissa Grain