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Home My WebLink About300141 07/12/16 y ��p" CITY OF CARMEL, INDIANA VENDOR: 36 222 ONE CIVIC SQUARE IU EALTH WORKPLACE SERVICES LLCCHECK AMOUNT: $""'63,260.80` x9` ,?� CARMEL, INDIANA 46032 204' RELIABLE PKWY CHECK NUMBER: 300141 MQiOii�o. CHI AGO IL 60686-0020 CHECK DATE: 07/12/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1201 4358800 750267 165.00 TESTING FEES 1201 4358600 750271 105.00 TESTING FEES 301 5023990 750320 4,374.16 OTHER EXPENSES 301 5023990 750498 40,105.06 OTHER EXPENSES 1205 4347500 750641 729.60 GENERAL INSURANCE 301 5023990 750733 16,974.96 OTHER EXPENSES 301 5023990 750777 807.02 OTHER EXPENSES VOUCHER NO. , WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) IU HEALTH WORKPLACE SERVICES LLC ALLOWED 20 ACCOUNTS PAYABLE VOUCHER 2046 RELIABLE PKWY IN SUM OF$ CITY OF CARMEL An invoice or bill to be properly itemized must show:kind of service,where performed,dates service CHICAGO, IL 60686-0020 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc. $270.00 Payee ON ACCOUNT OF APPROPRIATION FOR Purchase Order# Human Resources Terms Date Due PO# ACCT# DATE INVOICE# DESCRIPTION DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT 750271 43-588.00 $105.00 1 hereby certify that the attached invoice(s),or 6/30/16 750271 June Wellness $105.00 1201 101 1201 101 750267 43-588.00 $165.00 bill(s)is(are)true and correct and that the 6/30/16 750267 June Occupational Family Drug Screens $165.00 1201 101 materials or services itemized thereon for 1201 1 101 which charge is made were ordered and received except Tuesday,July 05,2016 e 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 Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer S� Indiana.University He'Ith.Workplace Services, LLC 950 North Meridian Street Suite 950. (City of Carmel). Indiana olis,:IN 46204 . .: - 31 Z 963:1535. TakID '20r0994452 . : . . . i voice Juh 3P:1.201& Bill.to:: Barbara Lamb For.'. Cit Carmel .Onsite City of Carmel• Onsite Wellness/June 2016 1 Civic Square Carmel,IN 46032 Inv ice#: 750271 . . Service Date Description. uanti Charge .Receipt A�diust Balance 06/02/2016 Quick Read UDS/6pan 1 15.00. kit Invoice# 750271 (continued)page 2 Service Date Description uanti Cha�ae. ReceiptAd'us 'Bal ance - - : 15.00 CITYCARO Invoice#.750271 Balanee Due:: : 105.00 MAKE PAYMENT TO THE BELOW ADDRESS.WITHIN 30 DAYS OF INVOICE DATE;-.PLEASE INCLUDE INVOIC #.ON CHECK: . u � ��. o JUL . . . . . 0 52016 Cl ger Indiana,University He I. Workplace Services;LLC 1Za\ 950 North Meridian Street quite,950 (City'of Carmel):. . w*. . . Indana olis,.IN 46204 . 31.7 963:1535. .: ' Tax ID '20r0994452 . voice Jun 30,.2016: Bill to:: Barbara Lamb For:'. .City.of Carmel .Onsite City of Carmel Onsite Occupational/June 2016 1 Civic Square . . Carmel,IN 46032- . Invoc 4-750261 . Service Date Description uanti Charge Receipt A�diust Balance. 06/29/2016 Quick Read UDS/6pan 15.00 06/06/2016 Quick Read UDS/6pan bl includes 1.00 15:00' . ''.15.00. kit Invoice.# . 75 1 267(continued)page 2 Service Date Description . . 165.00. . MAKE PAYMENT TO.THE BELOW ADDRESS WI HIN'30 DAYS OF.INVOICE DATEE-.PLEASE INCLYJDE INVOICI #ON CHECK Submitted To. . JUL.0' 5 20 1.6 Clergy Treasurer VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) ALLOWED 20 ACCOUNTS PAYABLE VOUCHER IU HEALTH WORKPLACE SERVICES LLC 2046 RELIABLE PKWY IN SUM OF$ CITY OF CARMEL An invoice or bill to be properly itemized must show:kind of service,where performed,dates service CHICAGO, IL 60686-0020 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc. $729.60 Payee ON ACCOUNT OF APPROPRIATION FOR Purchase Order# General Administration Terms Date Due PO# ACCT# DATE INVOICE# DESCRIPTION DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT 750641 43-475.00 $729.60 1 hereby certify that the attached invoice(s),or 6/30/16 750641 EAP Services $729.60 1205 101 1205 101 bill(s)is(are)true and correct and that the materials or services itemized thereon for which charge received except Tuesday,July 05,2016 I hereby certify that the attached invoice(s),or bill(s),is(are)true and correct and I have audited same in accordance with IC 5-11-10-1.6 20 Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer 'Indiana University Heath Workplace Services;LLC. � . 950 North Meridian Street Suite 950 (Cityof Carmel) Ind'ianap lis,'IN 46204 . . 317 963=1535. .: T2z 1D '20x0994452 . . IT voice . . '40630.-2016.'. Bill to: Barbara-Lamb'_ For: City"of"Carmel :Onsite „ , . City of Carmel-Onsite EAP Services/June 2016. 1 Civic Square" . Carmel,IN 46032-. Invoic # 750641 Service Date Description uanti : C 'are Receipt dust Balance 06/01/2016 EAP Services 608.00. '729.60 729.60 CIWCARO . Invoice#. 750641 Balance Due: 729.60 MAKE PAYMENT TO THE BELOW ADDRESS.WI HIN 30'DAYS.OF INVOICE DATE'-PLEASE INCLUDE, INVOIC #ON,CHECK Submitted TO. ;1UL; 0 5 2016 Clerk Treasurer VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) IU HEALTH WORKPLACE SERVICES LLC ALLOWED 20 ACCOUNTS PAYABLE VOUCHER 2046 RELIABLE PKWY IN SUM OF$ CITY OF CARMEL An invoice or bill to be properly itemized must show:kind of service,where performed,dates service CHICAGO, IL 60686-0020 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc. $62,261.20 Payee ON ACCOUNT OF APPROPRIATION FOR Purchase Order# 301 Medical Fund Terms Date Due PO# ACCT# DATE INVOICE# DESCRIPTION DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached,invoice(s)or bill(s)) AMOUNT 750320 50-239.90 $4,374.16 1 hereby certify that the attached invoice(s),or 6/30/16 750777 June Supply $807.02 301 301 301 301 750777 50-239.90 $807.02 bill(s)is(are)true and correct and that the 6/30/16 750733 June Misc Onsite $16,974.96 301 301 1 materials or services itemized thereon for 301 1 301 750 0-2-39:9 —$16 7496 750320 June Onsite Fees $4,374.16 301 301 which charge is made were ordered and 301 301 750498 50-239.90 $40,105.06 received except 6/30/16 750498 June Staff Time $40,105.06 301 301 301 301 Tuesday,July 05,2016 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 Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer 3i; Indiana University Health Workplace Services;LLC 950 North Meridian Street te, 50 Indianap�Is9N 46204 . 31-Z'963=1535. .: Ta zID IL 20.-0994452'. Ir Voice' Jun 301.2016' . Bill.to: Barbara Lamb : For: City of Carmel .Onsite _City of Carmel--Onsite Onsite Fee's/June 2016 1 Civic Square . • . . . . . Carmel,IN 46032-. . . In voic #: 150320 Service Date Description. uanti . Chatge Regain t dust . Balance 06/01/201.6. City.of Carmel;Sports 1.lerfoftfian.cei. 1.00 1;800:00 1800.00 Lease 06/01/2016: : City.of Carmel:Clinic uild Out .1.00 2,574:16 2574.16 CITYCARO Invoice#.750320 Balance Due:: 4374.16 MAKE PAYMENT TO THE BELOW ADDRESS.WI HIN30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICI #ON CHECK Submitted T® JUL-0.52016- Clerk Tre'8Surer Indiana University Health Workplace Services, LLC -3J) 950 North Meridian Street Suite 950 (City of Carmel) Indianap lis, IN 46204 317-963-1535 Tax ID 20-0994452 Ir voice JunE 30, 2016 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Staff Time/June 2016 1 Civic Square Carmel,IN 46032- Invoic # 750498 Service Date Description Quanti Charge Recei 1 Adjust Balance 06/01/2016 M.A.Staff Time 9.50 266.00 266.00 Kimberly Pride 06/01/2016 N.P.Staff Time 4.00 450.72 450.72 Dr.Fagan 06/01/2016 MD Staff Time 5.00 875.00 875.00 Dr.Fagan: 06/01/2016 R.N.Staff Time 9.50 589.00 589.00 Mareesa Marlin 06/02/2016 MD Staff Time 4.00 700.00 700.00 Dr.Fagan 06/02/2016 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride 06/02/2016 Health Coach Staff Tir ie 3.50 224.00 224.00 Marissa Grant 06/02/2016 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin 06/03/2016 MD Staff Time 5.00 875.00 875.00 Dr.Fagan 06/03/2016 M.A.Staff Time 6.50 182.00 182.00 Kimberly Pride 06/03/2016 Health Coach Staff Time 5.50 352.00 352.00 Marissa Grant 06/03/2016 R.N.Staff Time 7.50 465.00 465.00 Mareesa Martin 06/06/2016 MD Staff Time 5.00 875.00 875.00 Dr.Fagan 06/06/2016 M.A.Staff Time 9.50 266.00 266.00 Kimberly Pride 06/06/2016 Health Coach Staff Ti e 3.00 192.00 192.00 Marissa Grant 06/06/2016 N.P.Staff Time 4.00 450.72 450.72 Tina Nitsos Invoice# 750498(continued)page 2 Service Date Description Quantily Charge Receipt Adiust Balance 06/06/2016 R.N.Staff Time 9.25 573.50 573.50 Mareesa Mai-tin 06/07/2016 MD Staff Time 6.00 1,050.00 1050.00 Dr.Fagan 06/07/2016 M.A.Staff Time 6.50 182.00 182.00 Kimberly Pride 06/07/2016 R.N.Staff Time 6.75 418.50 418.50 Mareesa Martin 06/08/2016 MD Staff Time 5.00 875.00 875.00 Dr.Fagan 06/08/2016 M.A.Staff Time 8.50 238.00 238.00 Kimberly Pride 06/08/2016 N.P.Staff Time 5.00 563.40 563.40 Tina Nitsos 06/08/2016 R.N.Staff Time 9.00 558.00 558.00 Mareesa Martin 06/09/2016 MD Staff Time 4.00 700.00 700.00 Dr.Fagan 06/09/2016 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride 06/09/2016 Health Coach Staff Tin ie 4.50 288.00 288.00 Marissa Grant 06/09/2016 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin 06/10/2016 MD Staff Time 5.00 875.00 875.00 Dr.Fagan 06/10/2016 M.A.Staff Time 6.50 182.00 182.00 Kimberly Pride 06/10/2016 Health Coach Staff Time 4.50 288.00 288.00 Marissa Grant 06/10/2016 R.N.Staff Time 7.50 465.00 465.00 Mareesa Martin 06/13/2016 M.A.Staff Time 9.00 252.00 252.00 Kimberly Pride 06/13/2016 Health Coach Staff Tii ie 3.00 192.00 192.00 Marissa Grant 06/13/2016 N.P.Staff Time 4.00 450.72 450.72 Tina Nitsos 06/13/2016 MD Staff Time 5.00 875.00 875.00 Dr.Fagan 06/14/2016 R.N.Staff Time 6.75 418.50 418.50 Mareesa Martin 06/14/2016 M.A.Staff Time 7.00 196.00 196.00 Kimberly Pride 06/14/2016 MD Staff Time 6.00 1,050.00 1050.00 Dr.Fagan 06/15/2016 R.N.Staff Time 9.25 573.50 573.50 Mareesa Martin Invoice# 750498(continued)page 3 Service Date Descdr)tio Quanti Charge Receipt Adiust Balance 06/15/2016 M.A.Staff Time 9.00 252.00 252.00 Kimberly Pride 06/15/2016 N.P.Staff Time 4.00 450.72 450.72 Tina Nitsos 06/15/2016 MD Staff Time 5.00 875.00 875.00 Dr.Fagan 06/16/2016 R.N.Staff Time 5.25 325.50 325.50 Mareesa Martin 06/16/2016 M.A.Staff Time 6.50 182.00 182.00 Kimberly Pride 06/16/2016 Health Coach Staff Tin e 0.50 32.00 32.00 Marissa Grant 06/16/2016 MD Staff Time 4.00 700.00 700.00 Dr.Fagan 06/17/2016 R.N.Staff Time 7.00 434.00 434.00 Mareesa Martin 06/17/2016 M.A.Staff Time 6.00 168.00 168.00 Kimberly Pride 06/17/2016 Health Coach Staff Tin te 8.50 544.00 544.00 Marissa Grant 06/17/2016 MD Staff Time 5.00 875.00 875.00 Dr.Fagan 06/20/2016 R.N.Staff Time 9.00 558.00 558.00 Mareesa Martin 06/20/2016 M.A.Staff Time 9.50 266.00 266.00 Kimberly Pride 06/20/2016 Health Coach Staff Ti e 3.00 192.00 192.00 Marissa Grant 06/20/2016 N.P.Staff Time 4.00 450.72 450.72 Tina Nitsos 06/20/2016 MD Staff Time 5.00 875.00 875.00 Dr.Fagan 06/21/2016 R.N.Staff Time 6.75 418.50 418.50 Mareesa Martin 06/21/2016 M.A.Staff Time 6.50 182.00 182.00 Kimberly Pride 06/21/2016 MD Staff Time 6.00 1,050.00 1050.00 Dr.Fagan 06/22/2016 R.N.Staff Time 9.00 558.00 558.00 Mareesa Marlin 06/22/2016 M.A.Staff Time 10.00 280.00 280.00 Kimberly Pride 06/22/2016 N.P.Staff Time 4.00 450.72 450.72 Tina Nitsos 06/22/2016 MD Staff Time 5.00 875.00 875.00 Dr.Fagan 06/23/2016 R.N.Staff Time 4.75 294.50 294.50 Mareesa Martin Invoice# 750 98(continued)page 4 Service Date Description Quantity Charge Receipt Adjust Balance 06/23/2016 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride 06/23/2016 Health Coach Staff Tim 0.50 32.00 32.00 Marissa Grant 06/23/2016 MD Staff Time 4.00 700.00 700.00 Dr.Fagan 06/24/2016 R.N.Staff Time 6.50 403.00 403.00 Mareesa Martin 06/24/2016 M.A.Staff Time 6.50 182.00 182.00 Kimberly Pride 06/24/2016 Health Coach Staff Tin a 8.50 544.00 544.00 Marissa Grant 06/24/2016 N.P.Staff Time 5.00 563.40 563.40 Tina Nitsos 06/27/2016 N.P.Staff Time 4.00 450.72 450.72 Pamela Pilcher 06/27/2016 MD Staff Time 5.00 875.00 875.00 Pilcher 06/27/2016 M.A.Staff Time 9.50 266.00 266.00 Kimberly Pride 06/27/2016 R.N.Staff Time 9.25 573.50 573.50 Mareesa Martin 06/27/2016 Health Coach Staff Tin ke 3.00 192.00 192.00 Marissa Grant 06/28/2016 MD Staff Time 6.00 1,050.00 1050.00 Pilcher 06/28/2016 M.A.Staff Time 6.50 182.00 182.00 Kimberly Pride 06/28/2016 R.N.Staff Time 6.75 418.50 418.50 Mareesa Martin 06/29/2016 N.P.Staff Time 4.00 450.72 450.72 Pamela Pilcher 06/29/2016 MD Staff Time 5.00 875.00 875.00 Pilcher 06/29/2016 M.A.Staff Time 9.00 252.00 252.00 Kimberly Pride 06/29/2016 R.N.Staff Time 9.00 558.00 558.00 Mareesa Mai-tin 06/30/2016 MD Staff Time 4.00 700.00 700.00 Pilcher 06/30/2016 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride 06/30/2016 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin 06/30/2016 Health Coach Staff Ti e 0.50 32.00 32.00 Marissa Grant .Invoice•# :750 .98(continued)page 5 Service Date. . Description Quantily Charge. Recei6t A!!us Balance CITYCARO Invoice# 750498 Balance Due:. 40105.06• , MAKE•PAYMENT.TO.THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-.PLEASE INCLUDE . INVOICE#ON CHECK Submitted To J. UL 0 2016 • Irk Tr' asurer 'Indiana;University;Hea th:Vllorkpl;ace Services; LLC. <>> 950 North Meridian Street: . —� Suite 950 (City of Carmel): Indianap Iis,:IN 46204: . 31.7 963:1535 Tax D 20r09944 I52 . . Ir Voice. Jun 30: 2016 Bill to: Barbara Lamb For: City of Carmel .Onsite City of Carmel-.Onsite Misc.Onsite/June 2016 1 Civic Square Carinel,IN 46032- Inv'id #. 750733 Service Date Description uanti Charge Reeei t . Adiust Balance 05/15/2016: Young;at Heart Mail-In s 1.00. 11280.50. 1280.50• 05/22/2016 Young at Heart Mail-In s 1.00 2;294:82: 2294.82 05/26/2016 _Young at Heart Clinic eds 1.00. . . : 933.12 933.12 05/31/2016: Onsite Lab Charges 1.00: 2;754:47 2754.47 May 2016.Labs'. 05/31/2016. Young at Heart Mail-Ir s• ].00, 2,403:18 2403.18 06/12/2016 Young;at Heart Mail s 1.00: 5944.71 _ 5944.71 06/13/2016 Yoiing at Heart Clinic eds, 1.00, 1,3.64.16 1364.16 CITYCARO Invoice'#. 750733 Balance Due: 16974:96. MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF'INVOICE DATE PLEASE INCLUDE' -INVOICE#ON CHECK= Submitted TO JUL 0 5 2016 '. Clerk Treasurer. Indiana University Hea th Workplace Services;LLC 950 North Meridian.Street Suite 950. (City of Carmel):. Indianap Iis,.IN 46204 . 3 1 Z 963=1535. .: Tak ID 11 .20:-0994452 . Ir Voice . . . 1 'June 30;2016: Bill.to:: Barbara Lamb. . For: City of Carmel Onsite' City of Carmel-Onsite" Supply Billing/June 2016. I Civic Square Carmel,IN 46032- Invoic #: 750777 . Service Date Description. Quant! Charge . Recelp AdLust Balance 06/01/2016. Onsite Operating Supp,ies, . : 1.00 807.02 807.02 June 2016 Supplies 'CITYCARO Invoice#. 750777 Balance Due: 807:02. -MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOIC .#ON CHECK Submitted To JUL.: 0 5 .2016: : . Clerk tr asurer