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HomeMy WebLinkAbout301116 07/25/16 0CITY OF CARMEL, INDIANA VENDOR: 00350364 ONE CIVIC SQUARE PUBLIC SAFETY MEDICAL SERVICES CHECK AMOUNT: $'....9,663.78" s. ?� CARMEL, INDIANA 46032 324 E NEW YORK ST SUITE 300 CHECK NUMBER: 301116 9�'��i6ri.�O'� INDIANAPOLIS IN 46204 CHECK DATE: 07/25/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1120 4340701 24831 28740 9,663.78 DEPARTMENT PHYSICALS VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995) ALLOWED 20 ACCOUNTS PAYABLE VOUCHER PUBLIC SAFETY MEDICAL SERVICES 324 E NEW YORK ST SUITE 300 IN SUM OF$ CITY OF CARMEL An invoice or bill to be properly itemized must show:kind of service,where performed,dates service INDIANAPOLIS, IN 46204 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc. Payee $9,663.78 Purchase Order# ON ACCOUNT OF APPROPRIATION FOR Terms Carmel Fire Date Due PO# ACCT# DATE INVOICE# DESCRIPTION DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT 28740 43-407.01 $9,663.78 1 hereby certify that the attached invoice(s),or 7/18/16 28740 $9,663.78 1120 101 1120 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,July 18,2016 David Haboush Fire Chief 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 20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer Public Safety Medical - INVOICE s : n Public Safety Medical Invoice Date, 07118/2016 . %L 324 E.New York Street Invoice# 00-28740 E Suite 300 Terms: Indianapolis,IN 46204 C Carmel Fire Department 1 CARMEFD >- Denise Snyder, Budget&Accred Mgr 2 Civic Square Carmel,IN 46032 Exclusively Serving Public Safety Professionals Since 9990. Date Employee Description Amount Balance Due 07/13/16 Anderson Kent W CMP(Camp Metabo is Panel)- 20.00 $20,00 CBC(Comp Blood Count $18.13 $18.13 Lipid Panel Blood 21.26 $21.26 Veni uncture $3.14 $3.14 HIV-4th Gen Rapid Test Error 0.00 $0.00 Baskerville Steven M. CMP(Comp Metabolic Panel 20.00 $20.00 CBC(Comp Blood Count 18.13 $18.13 Li id Pane Blood 21.26 $21.26 Veni uncture $3.14 $3.14 IV-4th Gen Rapid Test(Error) $0.00 $0.00 SaWerville.Steven P. CMP(Comp Metabolic ane 20 00 $20.00 CBC(Como Blood Count) 18.1 8 3 Li 'd Panel(Blood) 21.26 $21.26 Venipuncture $3.14 $3.14 PSA-Prostate Specific A Blood 36.59 $36.59 Benbow,lQp S. CMP(Comp Metabolic Panel 20.00 $20.00 CBC(Come Blood Count 18.13 $18.13 Li id Panel Blood 21.26 $21.26 Veni uncture $3.14 $3.14 HIV-4th Gen Rapid Test Error 0.00 $0.00 PSA-Prostate Specific A Blood $30.59 $36.59 Bowles Orbie H. CMP(Comp Metabolic Panel 20.00 $20.00 CBC(Como Blood Count 18.13 $18.13 Li id Pane (Blood) $21.261 Venipundure $3.14 HIV-4th Gen Rapid Test Error 0.00 $0.00 PSA-Prostate Specific A Blood 36.59 $36.59 Brandt Gary D. CMP ComP Metabolic Panel 20.00 $20.00 CBC(Comp Blood Count 18.13 $18.13 LI id Panel Blood 21.26 $21.26 Venipuncture $3.14 $3.14 HIV-4th Gen Rapid Test Error 0.00 $0.00 PS -Prostate Specific A Blood 36.59 $36.59 Brant,Kenneth E. CMP Co Metabolic Panel) 20.00 $20.00 CBC(Como Blood Count) $18.13 $18.13 Li id Panel(Blood) $21.26 $21,26 Veniouncture $3.14 93.14 Public Safety Medical - INVOICE I! Public Safety Medical Invoice Date: 07/18/2016 i 324 E.New York Street invoice# 00-28740 E Suite 300 Terms: Indianapolis, IN 46204 o Cannel Fire Department I CARMEFD t- Denise Snyder,Budget&Accred Mgr m2 Civic Square Carmel,IN 46032 Exclusively Serving Public Safety Professionals Since 1990. Date Employee Description Amount Balance Due IV-4th Gen Ranid Test(Error) $0,00 $0.00 PSA-Prostate Specific A Blood $36.59 $36.59 Brisco,Michael D. CMP(Comp Metabolic Panel 20.00 $20.00 CBC(Comp Blood Count $18.13 $18.12 Lipid Panel Blood 21.26 $21.26 Venipuncture $3.14 $3.14 HIV-4th Gen Ra id Test Error 0.00 $0.00 PSA-Prostate Specific A Blood 36.59 $36.59 Cromlich Mark A. CMP Com Metabolic Panel) 20.00 1 $20.00 CBC Com Blood Count) 18.13 $18.13 Lipid Panel Blood $21.26 $21.26 Veniouncture $314 $3,14 HIV-4th Gen Rapid Test(Error) $0.00 $0.0 PSA-Prostate Specific A Blood $36.59 $36.59 Cummins,Frank C. CMP CornP Metabolic Panel 20.00 $20.00 CBC(Comp Blood Count $18.13 $18.13 U id Panel Blood $21.26 $21.26 Venipuncture $3.14 $3.14 HIV-4th Gen Rapid Test Error 0.00 so.001 PSA-Prostate Specific A Blood t$20.00 36.59 Essex Co C. CMP Com Metabolic Panel 20.00 CBC o Blood Count 18 1Li ' e Blood Ve ' u cue $3.14 HIV-Atb Gen Rapid Test r 0.00 $0,00 Harrington,Adam C. CMP(Comp Metabolic Panel 20.00 $20.00 CBC(Comp Blood Count $18.13 $18.13 Li id Panel Blood 21.26 $21.26 Veni uncture $3.14 $3.14 HIV-4th Gen Rapid Test Error 0.00 $0.00 PSA-Prostate S ecific A Blood 36.59 $36.59 Haymaker.Samuel K. CMP(Camp Metabolic Panel 20.00 $20.00 CBC(Comp Blood Count 18.13 $18.13 Li id Pane (Blood) 21.26 $21.261 Veni u c ure S3.14 $3.141 V-4than Ra id Test(Error) S00 0 00 S -Prnstate S e 'i BI od 36 $36.591 Public Safety Medical - INVOICE .p Public Safety Medical Invoice Date: 07/18/2016 ' 324 E.New York Street Invoice# 00-28740 E Suite 300 Terms: r- W Indianapolis,IN 46204 , •ti G Carmel Fire Department!CARMEFD H Denise Snyder, Budget&Accred Mgr m 2 Civic Square Carmel,IN 46032 Exclusively Serving Public Safety Professionals Since 9990. Date Employee Description Amount Balance Due ea ner Joel S P Co Metabolic a $20.00 0 CBC(Comp Blood Count $16.13 $18.1 Li id Panel Blood $21.26 21.26 Venipuncture $3.14 $3.14 HIV-4th Gen Rapid Test Error 0.00 $0.00 Heinlein Robert A. CMP(Comp Metabolic Panel 20.00 $20.00 CBC(Comp Blood Count 18.13 $18.13 Li id Pane! Blood 21.26 $21.26 Veni uncture $3.14 $3-14 HIV-4th Gen Ra id Test Error $0.00 $0.00 Hand Robert P. CMP(Comp Metabolic Panel 20.00 $20.00 C8C(Corno Blood Count 18. 3 $18.13 Li id Panel(Blood) $21.26 $21.26 Venipuncture $3.14 $3.14 HIV-4th Gen Rapid Test Error 0.00 $0.00 PSA-Prostate Specific A Blood 6.59 $36.59 Hutchison Brian P. CMP Com Metabolic Panel $20.00 20.00 CBC Com Blood Count 18.13 18.13 Li id Panel Blood 21.26 21.26 Veni uncture $3.14 $3.14 HIV-4th Gen Rapid Test Error 0.00 $0.00 Johnson,Jeremy S C Co Metabolic el 20.00 $20.00 CBC(Como Blood Countl $18.13Count $18.13 L' 'd et(Blood) 21.26 $21.26 Venipuncture- $3.14 $3.14 HIV-4th Gen Rapid Test Error $0.00 $0.00 PSA-Prostate Specific A Blood 36.59 $36.59 Keaton AnthonyR. CMP Comp Metabolic Panel 20.00 $20.00 CBC(Comg Blood Count $18.13 $18.13 Lipid Panel Blood $21.26 $21.26 Venipuncture $3.14 $3.14 V-4th Gen Rapid Test Error 0.00 $0.00 PS -Prostate Specific A Blood 36.59 $36.59 Le ze Jr. Theodore A. CMP Momp Metabolice .00 CBC(Comp Blood Co $18.13 8 3 Lipid Panel(Blood) 26 $21.26 Venloundure $3,14-- 3 Public Safety Medical - INVOICE Public Safety Medical Invoice Date: 0711812016 324 E. New York Street Invoice# 00-28740 a Suite 300 Terms: IY Indianapolis,IN 4620411 o Carmel Fire Department/CARMEFD H Denise Snyder, Budget&Accred Mgr 2 Civic Square Carmel,IN 46032 Exclusively Serving Public Safety Professionals Since 9990. Date Employee Description Amount Balance Due IV-4th Gen Raoidest $0,00 .00 PSA-Prostate Specific A Blood 36.59 $36.59 Marcum Bradley D. CMP(Comp Metabolic Panel $20.00 $20.00 CBC(Camp Blood Count 18.13 $18.13 Lipid Panel Blood 21.26 $21.26 Venipuncture $3.14 $3.14 HIV-4th Gen Rapid Test Error 0.00 $0.00 PSA-Prostate Specific A Blood 36.59 $36.59 Martin David D. CMP(Comp Metabolic Panel 20.00 $20.001 CBC lComp Blood Countl $18.13 $18.13 'd Panel(Blood) 21.26 $21.26 e ' cue $3.14 $3,14 HIV-4th Gen Rapid Testor 0 00 $0.00 PSA-ProstateSpecific Blood $36.59 $36.59 Martin Richard A. CMP(Comp Metabolic Panel $20.00 $20.00 CBC(Comp Blood Count 18.13 $18.13 LI id Panel Blood $21.26 21.26 Veni uncture $3.14 $3.14 HIV-4th Gen Rapid Test Error 0.00 $0.00 PSA-Prostate Specific A Blood 36.59 $36.59 McNee ichae CMP(Comp Metabolic Panel 20.00 $20.00 CSC(Camp Blood Count) 1813 $18.13 Li id Panel(Blood) .26 $21.26 Veni uncture $3.14 $3,14 HIV-4th Gen Rapid Test Error $0.00 $0.00 PSA-Prostate Specific A Error $0.00 $0.00 Mead David L. CMP(Comp Metabolic Panel $20.00 $20.0 CBC(Comp Blood Count $18.13 $18.13 Li id Panel Blood 21.26 $21.26 Veni uncture $3.14 $3.14 HIV-4th Gen Rapid Test Error 0.00 $0.00 PS -Prostate Specific An(Bloodl $36.59(Blood $36.59 Mulford David A. CMP(Comp melaWicPanel) 20.00 $20.00 CBC(Como BloodCount) $18.13 $18.131 Li id Panel(Blood) 26 6 c r 3. -!:3 14 V- t e TestE or 0 0 0 Public Safety Medical - INVOICE Public Safety Medical Invoice Date: 07198/2016 324 E.New York Street Invoice# 00-28740 E Suite 300 Terms: Ig Indianapolis, IN 46204 o Carmel Fire Department/CARMEFD I- Denise Snyder,Budget&Accred Mgr 2 Civic Square Carmel,IN 46032 Exclusively Serving Public Safety Professionals Since 1990. Date Employee Description Amount Balance Due, A-Prostate Specific ood $36,59 $36.69 Osborne,Scott IC CMP LComp Metabolic Panel 20.00 $20.00 CSC(Comp Blood Count $18.13 $18.13 Li id Panel Blood $21.26 $21.26 Venipuncture $3.14 $3.14 HIV-4th Gen Rapid Test Error 0.00 $0.00 PSA-Prostate Specific A Blood 36.59 $36.59 Plumer.Charles J. CMP(Camp Metabolic Panel 20.00 $20.00 CBC(Como Blood Count $18.13 $18.1 Lipid Pane[ Blood) $21-26 $21.26 Venin-uncture $3.14 $3.14 V-4th Gen Raold Test(Error) $0.00 S -Prostate Specific Aa f Blood $36.59 $36.5 Rohr,Christopher M. CMP(Comp Metabolic Panel $20.00 20.OD CBC(Camp Blood Count $18.13 $18.13 Li id Panel Blood 21.26 $21.26 Veni uncture $3.14 $3.14 HIV-4th Gen Rapid Test Error $0.00 $0.00 PSA-Prostate Specific A Blood 36.59 $36.59 Russel Grant W. CMP(Comp Metabolic Panel 20.00 $20.00 CBC(Comp Blood Count 18.13 $18.13 id Panel(Blood) 21.26 $21.26 Venipuncture 3.1 3 4 I -4th Gen Raoid Test(Error) $0.00 0. nchgaler.Dustin D. CMP(Comp Metabolic Panel) $20.00 120.00 CBC(Comp Blood Count $18.13 $18.13 Lipid Panel Blood 21.26 $21.26 Venipuncture $3.14 $3.14 HIV-4th Gen Rapid Test Error $0.00 $0.00 Sharp,Adam C. CMP(Camp Metabolic Panel 20.00 $20.00 CBC(Comp Blood Count 18.13 $18.13 WPM Panel-(Blood 21.26 $21.26 Veninuncture $3.14 $3.14 HIV-4th Gen RaddTest (Error 0.00 $0.00 PSA-Prostate Specific Blood) $36.59 S36,59 Sutton,Sean B. C C Metabolic Panel) 20.00 $20.0 CBG Co Blood Count) 1 Public Safety Medical - INVOICE Q 12 Public Safety Medical invoice Date: 07/1812016 324 E. New York Street ` +� Invoice# 00-28740 ® Suite 300 Terms; 12 Indianapolis,IN 46204 c Carmel Fire Department 1 CARMEFD H Denise Snyder, Budget&Accred Mgr 2 Civic Square Carmel,IN 46032 Exclusively Serving Public Safety Professionals Since 1990. Date Employee Description Amount Balance Due Li id Panel(Bloqd) 1.26 $21.26 Venipuncture $3.14 $3.14 HIV-4th Gen Rapid Test Error $0.00 $0.00 PSA-Prostate Specific Ag(Bloodl $36.59 $36.59 wendzel Jason D. CMP(Comp Metabolic Panel $20.00 $20.00 CSC Com Blood Count $18.13 $18.13 Li id Panel Blood 21.26 $21.26 Veni uncture $3.14 $3.14 HI -4th Gen Rapid Test(Errorl $0.00 $0.00 07114116 llen Brad A. CMP CoMetabolic a 20.00 $20,00 CBC(Camp Blood Countl $18.13 $18.13 Li id Pan (Blood) $21.26 $21.26 Ve i unci re $114 $3,14 Anderson Donovan Cory CMP(Comp Metabolic Panel t$21.26 $20.0 CBC Com Blood Count $18.13 Li id Panel Blood 21.26Veni uncture 3.1PSA-Prostate S ecific A Blood 36.59 Bene Jonathan R. CMP(Come Metabolic Panel 20.00 $20.00 CBC(ComD Blood Count 18.13 $18.13 Livid Panel Blood 21.26 $21.26 Veni uncture $3.14 Butts Joseph A. CMP(Corno Metaholir,Panell $20.00 $20,00 CBC(Como B ood Count $18,13 $18.131 Lipid Panel(Blood) 21.26 $21.26 Venipuncture $3.14 $3.14 PSA-Prostate Specific A Blood $36.59 $36.59 Butts Renee L. CMP(Comp Metabolic Panel 20.00 $20.00 CBC(Comp Blood Count 18.13 $18.13 Li id Panel Blood $21.26 $21.26 Veni u cture $3.14 $3.14 Cox Jordan R. CMP(Como Metabolic Panel) 20.00 $20.00 CBC(Como Blood Count) $18,1 Lipid P nel(Blood) 21.26 $21,26 Venlouncture $3.14 $3.14 Cox,Jusfin omr)Metabolic Panel) $20.06 $20.00 CBQ(Cornp BloodCount) $18.13 Public Safety Medical - INVOICE 1° Public Safety Medical Invoice Date: 07118/2016 3 324 E.New York Street invoice# 00-28740 E Suite 300 Terms: w Indianapolis,IN 46204 C Carmel Fire Department 1 CARMEFD 1- Denise Snyder, Budget&Accred Mgr 2 Civic Square Carmel,IN 46032 Exclusively Serving Public Safety Professionals Since 9990. Date Employee Description Amount Balance Due Pane Blood 12 $21,26 Venipuncture $3.14 $3.14 Crane Rnrry I CMP(Comp Metabolic Panel $20.00 $20.00 CBC(ComD Blood Count $18.13 $18.13 Li id Panel Blood 21.26 $21.2 Venipuncture $3.14 $3.14 PSA-Prostate Specific A Blood 36.59 $36.59 Deitsch Marc W. CMP(Comp Metabolic Panel 20.00 $20.GO CBC Momp Blood Count $18.13 $18.13 Li 'd Panel Blood 21.26 $21.26 Veni u cture $3.14 $3.14 DeLona.Michael T. CMP Momo Metabolic Panel) 00 $20.0 CBC(Comp Blood Count) 18. 3 Li id Panel Blood $21.26 $21.26 Venipuncture $3.14 $3.14 PSA-Prostate Specific A Blood 36.59 $36.59 Edwards Daniel E. CMP(Comp Metabolic Panel $20.00 $20.00 CSC(Comp Blood Count $18.13 $18.13 Li id Panel Blood 21.26 $21.2 Veni uncture 3.14 $3.14 PSA-Prostate Specific A Blood 6.59 $36.59 Ellison Christopher M. CMP Comy Metabolic Panel 20.00 20.00 CBC(Como Blood Count 18.13 $18.13 Lipid Pae (Blood) $21.26 $21.26 Venjouncture $3.14 $3.14 PSA-Prostate Specific A Blood $36.59 $36.59 Frost Bruce S. CMP Comp Metabolic Panel 20.00 $20.0 CBC(Comp Blood Count $18.13 $18.13 Li id Panel Blood 21.26 $21.2 Venipuncture $3.14 $3.14 PSA-Prostate Specific A Blood 36.59 $36.591 Greiner Brandon J. CMP(Comp Metabolic Panel 20.00 $20.00 CBC(Comp Blood Count 18.13 $18.13 Li 'd Panel(Bloodl $21.26 $21,2 Venipuncture $3.14 $3,14 Grimes.Jeffrey CMP Momp Metabolic Eane $20,00 $20.0 8 Blood Count) 8 .13 Public Safety Medical - INVOICE Public Safety Medical Invoice Date: 07118/2016 { 324 E. New York Street Invoice# 00-28740 Suite 300 Terms: w Indianapolis,IN 46204 y i o Carmel Fire Department/CARMEFD H Denise Snyder, Budget&Accred Mgr m 2 Civic Square Carmel,IN 46032 Exclusively Serving Public Safety Professionals Since 9994. Date Employee Description Amount Balance Due Uoid Panel(Blood) $21.26 921.2 Veni uncture $3.14 $3.1 PSA-Prostate Specific A Blood $36.59 $36.59 Gu el Mark E. CMP(Comp Metabolic Panel 20.00 20.00 CBC(Comp Blood Count $18.13 $18.13 Lipid Panel Blood $21.26 $21.26 Venipuncture $3.14 $3.14 PSA-Prostate Specific A Blood 36.59 $36.59 boush David G. CMP(Comp Metabollc Panel 20.00 $20.00 CBC(Comp Blood Count) 18.13 18.13 Livid Panel Rood) 21.26 $21.2 Venil2unotgre $3.14 $3.1 PSA-Prostate S e 'fic o d $36.59 $36,5 Haus Joshua S. CMP.(Comp Metabolic Panel $20.00 $20.00 CBC(Comp Blood Count 18.13 $18.13 Li id Panel Blood $21.26 $21.26 Veni uncture $3.14 $3.14 Maners Jeremy B. CMP ComP Metabolic Pane{ 20.00 $20.00 CBC(Comp Blood Count 18.13 18.13 Li id Panel Blood 21.26 $21.2 Venipuncture $3.14 $3.14 Marvel Thomas L. CMP(Comp Metabolic Panel) $20.00 $20.00 CBC(Corno Blood Count) 18.13 $18.13 Li id Panel Blood 6 $21.26 Veninuncture $3,14 McNair,Travis L. CMP(Comp Metabolic Panel 20.00 $20.00 CBC(Comp Blood Count 18.13 $18.13 Li id Panel Blood $21.26 $21.26 Venipuncture $3.14 $3.14 Mead Jr. Donald R. CMP(Comp Metabolic Panel 20.00 $20.00 CBC(Comp Blood Count 18.13 $18.13 Ll id Panel(Blood) 21.26 $21.26 Veni uncture $3.14 $3.141 PSA-Prostate Specific A Blood) $36.59 3659 dlen Michael J. CMP(Comp Metabolic Panel $20.00 20 00 CBC(Co BloodCount) 8.13 $ 8 3 -Lipid Panel(Blood) 21.26 2 Public Safety Medical - INVOICE i2 Public Safety Medical Invoice Date: 07/18/2016 ' 324 E. New York Streeti� Invoice# 00-28740 E Suite 300 Terms; p� Indianapolis, IN 46204 Carmel Fire Department/CARMEFD Denise Snyder, Budget&Accred Mgr m 2 Civic Square Carmel, IN 46032 Exclusively Serving Public Safety Professionals Since 1990. Date Employee Description Amount Balance Due Ve ' u ct re $3.14 $3.141 PSA-Prostate Specific A Blood 36.59 $36.59 Mitchell James C. CMP(Comp Metabolic Panel 20.00 $20.00 CBC(Comp Blood Count $18.13 $18.13 Li id Panel Blood $21.26 $21.26 Venipuncture $3.14 $3.14 Mowery,AnthonyW. CMP(Comp Metabolic Panel 20.00 $20.001 CBC(Comp Blood Count 18.13 $18.131 Li id Panel Blood 21.26 $21.26 Ve i uncture $3.14 $3.14 c .Wes W CMP(Comp Metabolic Panel $20,00 $20.00 CBC(Comii Blood Count 18.13 $18.13 Uoid Panel(Blood) 21.26 $21.26 Veni uncture $3.14 $3.14 Peterson Vernon(Al)A. CMP(CornD Metabolic Panel 20.00 $20.00 CBC(Como Blood Count 18.93 $18.13 Li id Panel Blood 21.26 $21.26 Venipuncture $3.14 $3.14 PSA-Prostate S ecifcc A Blood 36.59 6.59 Phillips,Craig M. CMP(Comp Metabolic Panel 20.00 $20.00 CBC(Comp Blood Count 18.13 $18.13 Upid Pan el B d 21.26 $21.26 Venirmneture $3.14 $3.14 PSA- rostate S ec' c Aa(Bloodl $36.69(Blood $36.591 Ray.Lucas M. CMP(Comp Metabolic a e .00 $20,00 CBC(Comp Blood Count $18.13 $18.13 Li id Panel Blood $21.26 $21,26 Venipuncture $3.14 $3.14 Reecer,Jason L. CMP(Como Metabolic Panel 20.00 $20.00 CBC(Comp Blood Count 18.13 $18-13 Livid Panel Blood 21.26 $21.26 Veninuncture $3.14 $3.14 PS -Prostate S ee c Blood 36.59 $36.59 E20.Reese Aaron P. CMP ComMetabolic Pae 0 20.00 CBC Com BloodCount) .13 18.13 L id Panel(Blood) 6 Venipuncture 34 $3.14 Public Safety Medical - INVOICE . Public Safety Medical Invoice Date: 07118/2016 324 E.New York Street Invoice# 00-28740 E Suite 300 Terms: w Indianapolis,IN 46204 C Carmel Fire Department/CARMEFD F- Denise Snyder, Budget&Accred Mgr 2 Civic Square Carmel,IN 46032 Exclusively Serving Public Safety Professionals Since 1990. Date Employee Description Amount Balance Due Rennert.Ian T. C Metabolic Panel) $20,00 $20,00 CBC(Camp Blood Count $18.13 $18.13 Lipid Panel Blood $21.26 $21.26 Veni uncture $3.14 $3.14 Robinson Mark G. CMP(Comp Metabolic Panel $20.00 $20.00 CBC(Comp Blood Count $18.13 18.13 Li id Panel Blood 21.26 $21.26 Veni uncture $3.14 $3.14 PSA-Prostate S ec c A Blood 36.59 136.59 Robinson Mitchell L. CMP(Comp Metabolic Panel) 20.00 CBC(Comp Blood Count $18.13 $18.13 i id Pael(Bloodl(Blood $21.26 $21.26 e u ct $3.14 $3-14 PSA-Prostate Specific A Blood $36.59 $36.59 Rutherford Justin CMP(Comp Metabolic Panel 20.00 $20.00 CBC(Comp Blood Count 18.13 $18.13 Li id Panel Blood 21.26 $21.26 Venipuncture $3.14 $3.14 Spelb(ing.James E. CMP(Como Metabolic Panel 20.00 $20.00 CBC Com Blood Count 18.13 $18.13 Li id Panel Blood $21.26 $21.2 e i u cture $3.14 $3.14 P Prostate Specific A Blood 6.59 $36.59 Steu[y.Kent C. CMP(Comp Metabolic ane 20.00 $20.00 CBC(Comp Blood Count) .1 18 3 Livid Panel Blood $21.26 $21.26 Venipuncture $3.14 $3.14 PSA-Prostate Specific A Blood 36.59 $36.59 Stroup,Scott A. CMP(Comp Metabolic Panel 20.00 $20.00 CBC(Comp Blood Count 18.13 $18.13 Li id Panel Blood 21.26 $21.26 Venipuncture $3.14 $3.14 PSA-Prostate Specific A Blood 36.59 $36.59 Thomas,Nathan C. CMP fComr) eta o is Panell Pane20.00 $20.00 BCC Blood Count) 18.13 $18.13 Li id Pae (Blood) 1 Veniguncture $3.14 $3.1 Public Safety Medical - INVOICE Public Safety Medical Invoice Date: 07118/2016 ' 324 E. New York Street Invoice# 00-28740 r: Suite 300 Tetras: { Indianapolis,IN 46204 c Carmel Fire Department/CARMEFD F- Denise Snyder, Budget&Accred Mgr 2 Civic Square m Carmel,IN 46032 Exclusively Serving Public Safety Professionals Since 9990. Date Employee Description Amount Balance Due Tierney,Scott A. CMP(Comp Metabolic Pae $20,00 $20,0 CBC(Camp Blood Count $18.13 $18.13 Li id Panel Blood $21.26 $21.26 Veni uncture $3.14 $3.14 PSA-Prostate Specific A Blood 5.59 $36.59 Viehe Richard E. CMP ComP Metabolic Panel $20.00 $20.00 CBC(Comp Blood Count $18.13 $18.13 -Lipid Panel Blood 21.26 $21.26 Veni uncture S3.14 3.1 PSA-Prostate Specific ( Blood) 36.5 Walk r.C 'sto a CMP Com Metabolic Panel) 20.00 C Co Blood Count 8. L' ' o Veni uncture $3.141 PSA-Prostate Specific A Blood $36.59 $36.59 WoodburnScott E. CMP(Gomp Metabolic Panel $20.00 $20.00 CBC(Comp Blood Count $18.13 $18.13 Li id Panel Blood 21.26 $21.26 Veni uncture $3.14 $3.14 Wyant.Andrew D. CMP(Como Metabolic Panel 20.00 $20.001 CBC(Como Blood Count 18.13 $1B.13 LiDid Panel Blood) $21,26 $21.26 Venit)uncture $3.14 $3.14 P5 -Prostate Snecific A (Blood) 36.59 $36.59 7115116 Ive Jo ata CMetabolic a 20.00 $20.00 CBC(Camp Blood Count $18.13 $18.13 Li id Panel Blood $21.26 $21.26 Venipuncture $3.14 $3.14 PSA-Prostate S ecific Aq(Bloodl $36.59 36.59 Collins Tony A. CMP(Comp Metabolic Panel 20.00 $20.00 CBC(Comp Blood Count 18.13 $18.131 Li id Pane[ Blood 21.26 $21.26 Venipuncture .14 $3.14 PS - ost a'S c c Ag(Bloodl $36.59 $36.59 Condra le E. CMP(Comn MetabolicPanel) 20.00 $20.00 CBC(Comp Blood out 18.13 $18.13 Upid Panel 0 2 $21,261 Public Safety Medical - INVOICE it Public Safety Medical invoice Date: 07118/2016 324 E. New York Street Invoice# 00-28740 E Suite 300 Terms: W Indianapolis,IN 46204 c Carmel Fire Department 1 CARMEFD F- Denise Snyder,Budget&Accred Mgr. 04 2 Civic Square Carmel,IN 46032 Exclusively Serving Public Safety Professionals Since 9990. :Date Employee Description Amount Balance Due Ve ' u c ure $314 $3.14 DeCrastos,Richard A. CMP(Comp Metabolic Panel $20.00 $20.00 CBC Com Blood Count $18.13 $18.13 Li id Panel Blood 21.26 $21.26 Veni uncture $3.14 $3.14 PSA-Prostate Specific A Blood $35.59 $36.59 Edwards Steven L. CMP(Comp Metabolic Panel 20.00 $20.00 CBC(Comp Blood Countl $18.13 $18.13 Li id Panel(Blood) 21.26 $21,2fi Venipuncture $3.14 $3.14 PSA-Prostate Specific Blood 36.59 $36.59 Faoin.TimothyC C Metabolic el 20.00 $20.00 CBG Co Blood Count) 18. 3 $18.13 Li id Panel Blood $21.26 $21.2 Venipuncture $3.14 $3.14 Fisher Gary L. CMP ComP Metabolic Panel) 20.00 $20.0 CBC(Comp Blood Count $18.13 $18.13 Li id Pane! Blood 21.26 $21.26 Veni uncture $3.14 $3.14 PSA-Prostate Specific A Blood 36.59 $36.59 Frye,Steven R. CMP(Comp Metabolic Pae 20.00 $20.00 CBC(Como Blood Count 18. 3 $18.13 Lipid Panel Blood $21,26 Venipuncture $3.14 $3,14 Gehlbach.Marc A. WE(Go p Metabolic Pa el $20,00 $20.001 CBC(Comp Blood Count 18.13 $18.13 Li id Panel Blood $21.26 $21.261 Venipuncture $3.14 $3.14 PSA-Prostate Specific A Blood 36.59 $36.59 Holden Adam D. CMP(Comp Metabolic Panel) 20.00 $20.00 CBC(Comp Blood Count 18.13 $18.13 Li id Panel Blood 21.26 $21.26 Veni uncture $3.14 $3.141 S -Prostate S ecific A Blood 36.59 $36.59 Jenkins John W. CMP CoMetabolic Panel) 000 $20.001 CBC(Comp Blood Count $18,13 18. 3 Livid Panel(Bhod) 2 Public Safety Medical - INVOICE I°- public Safety Medical Invoice Date: 07/18/2016 324 E.New York Street Invoice# 00-28740 S Suite 300 Terms: Indianapolis, IN 46204 C Carmel Fire Department/CARMEFD h Denise Snyder,Budget&Accred Mgr m 2 Civic Square Carmel,IN 46032 Exclusively Serving Public Safety Professionals Since 9990. Date Employee Description Amount Balance Due Veninuncture $3,14 $3.14 Kelsheimer,Troy W. CMP(Como Metabolic Panel $20.00 $20.00 CBC(Como Blood Count 18.13 $18.13 Li id Panel Blood 21.26 $21.26 Venipuncture $3.14 $3.14 PSA-Prostate Specific A Blood $36.59 $36.59 Kinney,Jared N. CMP ComP Metabolic Panel 20.00 $20.00 CBC(Como Blood Count 18.13 $18.13 Li 'd Panel(Stood) 21.26 $21.26 Veniouncture $3.14 $3.14 PSA-Prostate Specific (Blood) $36.59 $36.59 Knott,Bruce A P(Comp Metabolic Panel) $20.00 $20.Q0 BC Co Blood Count) $18.13 $18.13 Li id Panel Blood $21.26 $21.26 Veni uncture $3.14 $3.14 PSA-Prostate Specific A Blood $36.59 $36.59 Love Joseph(Bradley) CMP(Como Metabolic Panel 20.00 $20.00 CBC(Como Blood Count 18.13 $18.13 Li id Panel Blood 21.26 $21.26 Veni uncture $3.14 $3.14 PSA-Prostate S ec f c A (Blood) 36.59 $36.59 Marsh, is ae A. CMP(Como Metabolic Panel) 20.00 $20.0Q CBC(Como Blood Count $1B.13 $18,1 Li id Panel B $21.26 $21.26 Ve i u c ure $3.14 $3,14 PSA-Prostate Specific A Blood $36.59 $36.59 McNab John D. CMP(Como Metabolic Panel 20.00 $20.00 CBC(Como Blood Count $18.13 lmg Lipid Panel Blood 21.26 $21.26 Venipuncture $3.14 $3.14 PSA-Prostate S ecific A Blood 36.59 $36.59 Mueller William C. CMP(Como Metabolic Panel 20.00 $20.00 CBC(Camp Blood Count 18.13 $18.13 Unid Panel(Blood) 21.2 6 Venipuncture $3.14 $3.14 Paddock,Ronald D. CMP Metabolic Panel) 20.00 $20.00 CBC(Como Blo-ocLO-ountl $18.133 Public Safety Medical - INVOICE _ a 1-° Public Safety Medical Invoice Date: 07118/2016 = 324 E. New York Street Invoice# 00-28740 _ E Suite 300 Terms: Indianapolis,IN 46204 C Carmel Fire Department 1 CARMEFD F- Denise Snyder,Budget&Accred Mgr m2 Civic Square Carmel,IN 46032 Exclusively Serving Public Safety Professionals Since 9990. Date Employee Description Amount Balance Due Li id el(Blood) 21.26 $21,2 Ven i uncture $3.14 $3.14 PSA-Prostate 5 ecific A Blood 36.59 6.59 Price Joseph P. CMP Com Metabolic Panel $20.00 20.0 CBC(Como Blood Count 18.13 $18.13 Lipid Panel Blood 21.26 $21.26 Veni uncture $3.14 $3.14 PSA-Prostate Specific A Blood 36.59 $36.59 Reeves. et P(Comn MetabolicPanel) $20.00 20 00 CBC(Camp Blood Count) $18,13 $18.13 Li id Panel Blood 21.26 $21.26 Veninuncture $3.14 $3.14 Rgynolds.Sham J. QMPMetabolic a 20 $20.0 CBC(Comp Blood Count $18.13 $18.131 Li id Panel Blood $21.26 N Veni uncture $3.14 PSA-Prostate S ecific A Blood $36.59 Starr Gre o A. CMP Cam Metabolic Pane! $20.00 CBC Cam Blaod Count 18.13 LI id Panel Blood 21.26 $21.26 Venipuncture $3.14 $3.14 PSA-Prostate S ecific Ag(Bloodl $36.59 $36.59 Stindle Kevin P. CMP(Comp Metabolic Panel 20.00 $20.00 BC(Como BloodCount) $18.13 3 Lipid Panel(Blood) $21.26 $21.261 Venipuncture $3.14 $3.14 itzig,Chad M. CMP ComP Metabolic Panel 20.00 $20.00 CBC(Comp Blood Count $18.13 $18.13 LJ ld Panel Blood 21.26 $21.26 Veni uncture $3.14 $3.14 Utzjq,Todd T. CMP(Camp Metabolic Panel 20.00 $20.00 CBC(Comp Blood Count 18.13 $18.13 Lipid Panel Blood 21.26 $21.26 Venipuncture $3.14 S -Prostate S ec f c. oodl $36.59 36.59 Voskuhl Mark J. C Co Metabolic Pae 20 00 $201,00 C Co o Co 8 3 $18.13 Public Safety Medical - INVOICE a a Public Safety Medical Invoice Date: 07/18/2016 � l� 324 E. New York Street Invoice# 00-28740 _ E Suite 300 Terms: tY Indianapolis, IN 46204 c Carmel Fire Department/CARMEFD f- Denise Snyder,Budget&Accred Mgr 2 Civic Square Carmel,IN 46032 Exclusively Serving Public Safety Professionals Since 1990. Date Employee Description Amount Balance Due i id e (Blood) 21.26 2 26 Venipuncture $3.14 $3.14 PSA-Prostate Specific A Blood 36.59 $36.59 Watts Trent E. CMP(Comp Metabolic Panell $20.00 $20.00 CBC(Como Blood Count 18.13 $18.13 Lipid Panel Blood 21.26 $21.26 Veni uncture $3.14 $3.14 PSA-Prostate S ecific A Blood 36.59 $36.59 Webb,Gregory-A. CMP(Comp Metabolic Panel 20.00 $20,00 CBC Co Blood Count) 18.13 $181 Lipid Panel(Blood) 21.26 $21.26 Veni u c ure $3.14 $3,14 SA-Prostate Specific Blood $36.59 $36.59 Weddin ton.Kurt L. CMP(Camp Metabolic Panel $20.00 $20.00 CBC(Comp Blood Count $18.13 $18.13 Lipid Panel Blood $21.26 $21.26 Venipuncture $3.14 $3.14 PSA-Prostate Specific A Blood $36.59 $36.59 Wilson Carlos A. CMP(Como Metabolic Panel 20.00 $20.00 CBC(Comp Blood Count 18.13 $18.13 Li 'd (Blood) 21.26 $21.26 Vanipuncture $3,14 $3.14 Workman William J. CMP mMetabolic Pae $20.00 0.00 CBC(Como Blood Countl $18.13 $18.1 L id Pae BI d $21.26 $21.26 Venipuncture $3.14 $3.14 PSA-Prostate Specific A Blood 36.59 $36.59 Young,Andrew S. CMP(Camp Metabolic Panel 20.00 $20.00 CBC(Comp Blood Count 18.13 $18.13 Li id Panel Blood $21.26 $21.26 Venipuncture $3.14 $3.14 Youna.Kevin M. CMP(Comp MetabolicPae 20.00 $20.00 CBC Cam Blood Count 18.13 $18.13 LI id Panel Blood 21.26 $21.26 Veni uncture $3,14 $3.14 Zeller,MichaelJ. CMP(Como MetabolicPanel) 20 $20.00 CBC Co D Blood Count) 8.1 Public Safety Medical - INVOICE 12 Public Safety Medical Invoice Date: 07/18/2016 y i� 324 E.New York Street Invoice# 00-28740 E Suite 300 Terms: W Indianapolis,IN 46204 ` o Carmel Fire Department I CARMEFD t— Denise Snyder, Budget&Accred Mgr 2 Civic Square Carmel, IN 46032 Exclusively Serving Public Safety Professionals Since 1990. Date Employee Description Amount Balance Due Hold Pae load 121,26 $21.26 Venipuncture $3.14 $3.14 Total Charges-> $9.,663.78 Total Payments&Balance Due->. $0.00:1 $9,653.78 Please write invoice number on payment check. Our Federal Employer identification number is 35-2079797. We greatly appreciate the opportunity to serve you. If you have any questions regarding this invoice, please contact Debbie Pieper at 317-964-2330.