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Home My WebLink About257213 04/05/16 G/ ;F• CITY OF CARMEL, INDIANA VENDOR: 367222 ' ONE CIVIC SQUARE IU HEALTH WORKPLACE SERVICES LLCCHECK AMOUNT: $"•+56,225.46' �` a� CARMEL, INDIANA 46032 2046 RELIABLE PKWY CHECK NUMBER: 257213 9M,«oN�. CHICAGO IL 60686-0020 CHECK DATE: 04/05/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 301 5023990 748237 4,374.16 OTHER EXPENSES 301 5023990 748238 36,092.50 OTHER EXPENSES 1205 4347500 748312 729.60 GENERAL INSURANCE 301 5023990 748671 12,767.20 OTHER EXPENSES 301 5023990 748831 2,262.00 OTHER EXPENSES ,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 Fhom, rates per day,number of hours, rate per hour, number of units, price per unit,etc. Payee Purchase Order No. Terms Date Due rvoice Date invoice# Description Amount Dept. Fund# (or note attached invoice(s)or bill(s)) 03/31/16 748831 $2,262.00 301 301 03/31/16 748237 $4,374.16 301 301 03/31/16 748671 $12,767.20 301 301 03/31/16 748238 $36,092.50 301 301 1 hereby certify that the attached invoice(s), or bill(s), is(are)true and correct and I have audited same in accordance with IC 5-11-10-1.6 , 20 Clerk-Treasurer VOUCHER NO. WARRANT NO. ALLOWED 20 IU HEALTH WORKPLACE SERVICES LLC 2046 RELIABLE PKWY IN SUM OF$ CHICAGO, IL 60686-0020 $55,495.86 ON ACCOUNT OF APPROPRIATION FOR 301 Medical Fund PO#/Dept. INVOICE NO. ACCT#/Fund AMOUNT Board Members x 748831 50-239.90 $2,262.00 1 hereby certify that the attached invoice(s), or 301 301 748237 50-239.90 $4,374.16 bills) is (are)true and correct and that the 301 301 materials or services itemized thereon for 748671 50-239.90 $12,767.20 301 301 which charge is made were ordered and 748238 50-239.90 $36,092.50 received except 301 301 Monday, April 04, 2016 Cost distribution ledger classification if claim paid motor vehicle highway fund Indiana University Health Workplace Services;LLC 950 North.Meridian Street Suite:960'(City of Carmel) . Indianapolis,.IN 46204 . 317-963=1585 . . . . �. Tax ID#.'20-0904452 Ilnvoce March,31;2016 : : : B11116- Barbara.Lamb For: :City of Carmel:-:Onsite - SuPP1 Billing/ ac201CitY of-Carmel, Onsite 6 Civic Square Carmel,IN .46032- Invoice#. .748831 Service Date Description Qbanti Charge .',• Receipt Adjust Balance 03/01/2016: Onsite Qperatirig Supplies 1::00. : 2;262.00 2262.00. March 2016 Supplies CITInvo YCARO: ice# 748831 Balance Due: 2262:00 MAKE PAYMENT TO THE BELOW ADDRESS:WITHIN'30:DAYS.OF INVOICE DATE=PLEASE INCLUDE INVOICE#ON.CHEC K SuAmistted T APR'® 4 .2016 Clerk T reasurer Indiana University Health Workplace Services;LLC 950 North Meridian Street .. . 950 Suite . Indianapolis, IN 46204: 317-963=1535 . Tax:I D#. 20-0994452 Invoice 31 ..2016; : . . • ' . . March , Bi11:to: . Barbara:Lamb . For:' :City of Carmel: Onsite City of-Cam el Onsite Onsite Fee's/March.2016 . 1 Civic Square Carmel,IN'.46032=. Invoice#: .748237 Service Date• . Description'. Quantitv Charge Recei Ad'us Balance : . 1;800.00 : 1800:00. . :03/01/20:16:.• City of Cannel Sports,Performance 1.00. . ' '• Lease' 03/01%2016: City of Carmel Clinic Build.Out : -.1.00 2;574.16' 2574.16. CITYCARO• Invoice# 748237 Balance Due: 4374:16 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30:DAYS OF INVOICE DATE PLEASE INCLUDE'. . .''. INVOICE.#ON.CHECK a S UA MIX Wed To ' . :APR 0.4 2016 Cle roasure Cut and mhim with mvment - - Indiana University Health Workplace Services, LLC . 950 North Meridian Street Suite'950 (City.of Carmel) Indianapolis, IN 46204 - 317-963-1535 , Tax-Q# 207.0994452 Invoice March 31; 201'6. Bill to: .. .Barbara:Lamb For: .City of Carmel: Onsite City of Carmel Onsite Misc.Onsite/March-2016 . I Civic Square Carmel;IN .46032-. " Invoice# 748671 • Service Date• . Description'. uanti Charas., Recei Ad'us Balance 02/17/20.16: : . Young at Heart:Clinic Meds. 1:00: .502:12 502:12' 02/19/2016 Young at Heari Ginic Meds, 1.00 345:28 .345.28. . 02/29/2016: Onsite.Lab Charges: 1.00 2;754.25 2754.25; February 2016 Labs 02/29/2016 Young at HeartMail-Ins .1.00 . 8,373:66 8373:66 . 02/29/2016 Young at Heait Clinic Meds 1.00 791.89 791'.89: CITYCARO - Invoice# 748671 Balance Due: 12767.20 MAKE PAYMENT TO THE.BELOW ADDRESS'.WITH1N30bAYS OF INVOICE DATE=PLEASE'INCLUDE. . INVOICE#.ON CHECK :. E16AR.0:4 -20.1.6 Submitted 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 March 31, 2016 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Staff Time/March 2016 1 Civic Square Carmel,IN 46032- Invoice# 748238 Service Date Descriptio Quanti Charge Recei Adiu-si Balance 02/29/2016 R.N.Staff Time -8.00 -496.00 -496.00 Mareesa Martin 03/01/2016 M.A.Staff Time 6.75 189.00 189.00 Kimberly Pride 03/01/2016 R.N.Staff Time 7.00 434.00 434.00 Mareesa Martin 03/01/2016 MD Staff Time 6.00 1,050.00 1050.00 Dr.Fagan 03/02/2016 M.A.Staff Time 6.50 182.00 182.00 Kimberly Pride 03/02/2016 R.N.Staff Time 5.50 341.00 341.00 Mareesa Martin 03/02/2016 MD Staff Time 5.00 875.00 875.00 Dr.Fagan 03/03/2016 M.A.Staff Time 6.00 168.00 168.00 Kimberly Pride 03/03/2016 R.N.Staff Time 5.50 341.00 341.00 Mareesa Martin 03/03/2016 Health Coach Staff Time 4.50 288.00 288.00 Marissa Grant 03/03/2016 MD Staff Time 4.00 700.00 700.00 Dr.Fagan 03/04/2016 M.A.Staff Time 6.50 182.00 182.00 Kimberly Pride 03/04/2016 R.N.Staff Time 6.50 403.00 403.00 Mareesa Martin 03/04/2016 Health Coach Staff Time 4.50 288.00 288.00 Marissa Grant 03/04/2016 MD Staff Time 5.00 875.00 875.00 Dr.Fagan 03/07/2016 Health Coach Staff Time 3.00 192.00 192.00 Marissa Grant 7Submitted To Ub �C�IerkTreasuirer Invoice# 748238 (continued)page 2 Service Date Descriptio Quanti Charae Receipt Ad'us Balance 03/07/2016 MD Staff Time 5.00 875.00 875.00 Dr.Fagan 03/07/2016 M.A.Staff Time 6.00 168.00 168.00 Kimberly Pride 03/07/2016 R.N.Staff Time 5.50 341.00 341.00 Mareesa Martin 03/08/2016 MD Staff Time 6.00 1,050.00 1050.00 Dr.Fagan 03/08/2016 M.A.Staff Time 7.50 210.00 210.00 Kimberly Pride 03/08/2016 R.N.Staff Time 8.50 527.00 527.00 Mareesa Martin 03/09/2016 MD Staff Time 5.00 875.00 875.00 Dr.Fagan 03/09/2016 M.A.Staff Time 7.00 196.00 196.00 Kimberly Pride 03/09/2016 R.N.Staff Time 5.75 356.50 356.50 Mareesa Martin 03/10/2016 Health Coach Staff Time 4.50 288.00 288.00 Marissa Grant 03/10/2016 MD Staff Time 4.00 700.00 700.00 Dr.Fagan 03/10/2016 M.A.Staff Time 5.50 154.00 154.00 Kimberly Pride 03/10/2016 R.N.Staff Time 6.75 418.50 418.50 Mareesa Martin 03/11/2016 Health Coach Staff Time 4.50 288.00 288.00 Marissa Grant 03/11/2016 MD Staff Time 5.00 875.00 875.00 Dr.Fagan 03/11/2016 M.A.Staff Time 7.00 196.00 196.00 Kimberly Pride 03/11/2016 R.N.Staff Time 7.75 480.50 480.50 Mareesa Martin 03/14/2016 Health Coach Staff Time 3.00 192.00 192.00 Marissa Grant 03/14/2016 MD Staff Time 5.00 875.00 875.00 Dr.Fagan 03/14/2016 M.A.Staff Time 6.00 168.00 168.00 Kimberly Pride 03/14/2016 R.N.Staff Time 6.50 403.00 403.00 Mareesa Martin 03/15/2016 MD Staff Time 6.00 1,050.00 1050.00 Dr.Fagan 03/15/2016 M.A.Staff Time 5.50 154.00 154.00 Kimberly Pride 03/15/2016 R.N.Staff Time 7.50 465.00 465.00 Mareesa Martin Invoice# 748238 (continued)page 3 Service Date Descriptio Quanti Charge Receip Adjust Balance 03/16/2016 MD Staff Time 5.00 875.00 875.00 Dr.Fagan 03/16/2016 M.A.Staff Time 5.50 154.00 154.00 Kimberly Pride 03/16/2016 R.N. Staff Time 6.50 403.00 403.00 Mareesa Martin 03/17/2016 Health Coach Staff Time 4.50 288.00 288.00 Marissa Grant 03/17/2016 MD Staff Time 4.00 700.00 700.00 Dr.Fagan 03/17/2016 M.A.Staff Time 5.50 154.00 154.00 Kimberly Pride 03/17/2016 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin 03/18/2016 Health Coach Staff Time 5.00 320.00 320.00 Marissa Grant 03/18/2016 MD Staff Time 5.00 875.00 875.00 Dr.Fagan 03/18/2016 M.A.Staff Time 6.00 168.00 168.00 Kimberly Pride 03/18/2016 R.N. Staff Time 7.00 434.00 434.00 Mareesa Martin 03/21/2016 Health Coach Staff Time 3.00 192.00 192.00 Marissa Grant 03/21/2016 MD Staff Time 5.00 875.00 875.00 Dr.Fagan 03/21/2016 M.A.Staff Time 6.00 168.00 168.00 Kimberly Pride 03/21/2016 R.N.Staff Time 5.50 341.00 341.00 Mareesa Martin 03/22/2016 MD Staff Time 6.00 1,050.00 1050.00 Dr.Fagan 03/22/2016 M.A.Staff Time 6.00 168.00 168.00 Katie Croucher 03/22/2016 R.N.Staff Time 7.50 465.00 465.00 Mareesa Martin 03/23/2016 MD Staff Time 5.00 875.00 875.00 Dr.Fagan 03/23/2016 M.A.Staff Time 5.00 140.00 140.00 Krystal Cheatham 03/23/2016 R.N.Staff Time 6.50 403.00 403.00 Mareesa Martin 03/24/2016 M.A.Staff Time 4.00 112.00 112.00 Krystal Cheatham 03/24/2016 Health Coach Staff Time 4.50 288.00 288.00 Marissa Grant 03/24/2016 MD Staff Time 4.00 700.00 700.00 Dr.Fagan Invoice# 748238 (continued)page 4 Seniice Date Description uantiCharge Recei Adjust Balance 03/24/2016 R.N.Staff.Time 6.75 418:50 . . . 418:50 Mareesa Martin 03/25/201.6 Health'Coach Staff Time 4.50 288.00 288.00 . Marissa Grant 03/25/2016 MD-Staff Time 5:00 $75:00. 875.00 Dr.Fagan 03/25/2016 M.A.Staff Time .5.00' 140.00: 140.00 Krystal,Clieatham 03/25/2016 'R-.N.Staff Time 7,75: 480.50 480:50, Mareesa. artin. 03%28/2016 . M:A:Staff Time 5.:50 5400 154.00.. Krystal Cheatham. 03%28/2016 . Health Coach Staff Time 3.00 192.00 192:00: Marissa Grant. 03/28/20,16. 1 MD Staff Time . 5.00 875.00 875.00 Dr.Fagan,. .' . 03/28/2016 R.N.Staff Time 5.50 341.00 341.00, Mareesa Martin. . 03/29/2016 : M.A.,Staff Time 6.50 1:82.00 182.00 Krysial Cheatham 03/29/2016 MD Staff Time e .6.00 1,050:00. 1050.00. '. Dr.Fagan 03/29/2016: : . R.N.Staff Time 7.50 465.00 465.00 ' Mareesa Martin 03%30/2016 MD.Staff Time 5.00 875.00 875.00 Dr.Fagan , 03/30/201.6• M.A.Staff Time. 5.50 154:00 154.00 Krystal Cheatham 03/30/2016 R.N.Staff Time .6.50 403.00 403.00 Mareesa Martin 03/3-1/2016 M.A.Staff.Time 4.50 126:00 126.00 Krystal Cheatham 03/31/2016. Health Coach Staff Time 4.50 . .288.00 288:00' Marissa Grant 03/31/2016MD Staff Time 4.00. 700.00 .700.00. .: Dr.Fagan 03/31/2016. R.N.Staff Time 5.00 310.00 310.00 'Mareesa Martin CITYCARO :Invoice# 748238•Balance Due: 36092.50 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF.INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK -. ('.W.-I retnm mith---f 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)) 03/31/16 748312 EAP services $729.60 1205 101 I hereby certify that the attached invoice(s), or bill(s), is(are)true and correct and I have audited same in accordance with IC 5-11-10-1.6 , 20 Clerk-Treasurer VOUCHER NO. WARRANT NO. ALLOWED 20 IU HEALTH WORKPLACE SERVICES LLC 2046 RELIABLE PKWY IN SUM OF$ CHICAGO, IL 60686-0020 $729.60 ON ACCOUNT OF APPROPRIATION FOR General Administration PO#/Dept. INVOICE NO. ACCT#/Fund AMOUNT Board Members 748312 I 43-475.00 I $729.60 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 Monday, April 04, 2016 Cost distribution ledger classification if claim paid motor vehicle highway fund Indiana University Health Workplace Services;LLC 950 North Meridian Street �15 Suite 950 (City of Carmel) SIndianapolis,,IN 46204'.. 12� . .. 317,_963:_1535.. Tax ID#.'20-0994452 . Invoice March. 31,.2016 Bill.to: . Barbara Lamb . For: City of Carmel: Onsite City of Carmel Onsite EAP Services/March 2016. 1 Civic Sgivare Carmel;IN 46032- Invoice#. .7483:12 . .. Service Date Description• Quant! Charae .Recei :.Ad"us Balance 03/01/2016: EAR Services 608.00• 729.60 '729:60. CITYCARO. Invoice.# 748312.Balance.Due: 729.60 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS-OF INVOICE DATE PLEASE INCLUDE INVOICE#ON CHECK APR 0 4.2016 LCler re-as, er