The URL can be used to link to this page

Home My WebLink About302242 08/22/16 CITY OF CARMEL, INDIANA VENDOR: 00350364 : ONE CIVIC SQUARE PUBLIC SAFETY MEDICAL SERVICES CHECK AMOUNT: $****'2,133.40* f. a° CARMEL, INDIANA 46032 324 E NEW YORK ST SUITE 300 CHECK NUMBER: 302242 gMiroii.io'` INDIANAPOLIS IN 46204 CHECK DATE: 08/22/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1120 4340701 24831 28831 2,133.40 DEPARTMENT PHYSICALS VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995) PUBLIC SAFETY MEDICAL SERVICES ALLOWED 20 ACCOUNTS PAYABLE VOUCHER 324 E NEW YORK ST SUITE 300 IN SUM OF$ 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. $2,133.40 Payee Purchase Order# ON ACCOUNT OF APPROPRIATION FOR Carmel Fire 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 24831 28831 43-407.01 $2,133.40 I hereby certify that the attached invoice(s),or 8/11/16 28831 $2,133.40 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 Friday,August 12, 2016 David Haboush Fire Chief 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 o Public Safety Medical Invoice Date: 08/03/2016 y a 324 E. New York Street Invoice# 00-28831 E Suite 300 Terms: W Indianapolis, IN 46204 ^ a ti C 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 E$21.26 Balance Due 07/25/16 Baskerville AnthonyA. CMP Com Metabolic Panel 20.00 CBC Com Blood Count $18.13 Li id Panel Blood $21.26 Veni uncture $3.14 PSA-Prostate Specific A Blood 36.59 $36.59 Bondurant Jeff S. 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 $3.14 $3.141 PSA-Prostate Specific A Blood 36.59 36:59 Ca shave Jeffrey A. CMP(Como Metabolic Panel 20.00 $20.00 CBC(Como 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 Drake Carl 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 PSA-Prostate Specific A Blood 36.59 $36.59 Freer Keith T. 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 $3.14 $3.14 PSA-Prostate S ecific A Blood 36.59 $36.59 Fuchs,Jeffery W. 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 Hughes,Chad L. 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 $3.14 $3.14 PSA-Prostate Specific A Blood $36.59 $36.59 Mason Bryan L. CMP(Comp Metabolic Panel 20.00 $20.00 CBC(Como Blood Count 18.13 S18.13 Public Safety Medical - INVOICE H Public Safety Medical Invoice Date: 08/03/2016 w 324 E. New York Street Invoice# 00-28831 E Suite 300 Terms: IY Indianapolis, IN 46204 C 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 LOW Panel Blood 21.26 $21.26 Venipuncture $3.14 $3.14 PSA-Prostate Specific A Blood $36.59 $36.59 NalleV,Marcus E. CMP Com 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 Smith Brian E. CMP(Como Metabolic 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 PSA-Prostate Specific A Blood 36.59 $36.59 Steele Jeffrey A. 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 Thordarson Erik M. CMP(Comp Metabolic Panel 20.00 $20.001 CBC(Comp Blood Count 18.13 $18.13 Lipid Panel Blood 21.26 $21.26 Veni uncture $3.14 $3.14 Utzig,Todd T. CMP(Comp Metabolic Panel 0.00 $0.00 CBC(Comp Blood Count 0.00 $0.00 Li id Panel Blood 0.00 $0.00 Veni uncture(N/C-Done 7/15/16 0.00 $0.00 PSA-Prostate Specific A Blood $0.00 $0.00 07/26/16 Dorsch James E. 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 Specific A Blood 36.59 $36.59 Frenzel Eric C. CMP(Comp 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 ecific A Blood 36.59 $36.59 Griffin Timothy M. CMP Com Metabolic Panel 20.00 Tgn.00 Public Safety Medical - INVOICE o Public Safety Medical Invoice Date: 08/03/2016 j r 324 E. New York Street Invoice# 00-28831 SSuite 300 -- � Terms: W Indianapolis, IN 46204 o Carmel Fire Department/CARMEFD F- 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 CBC(Como Blood Count 18.13 $18.13 Lipid Panel Blood $21.26 $21.2 Venipuncture $3.14 $3.14 Hoover AnthonyB. CMP Com 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 Lux Michael T. 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 3.14 3.14 PSA-Prostate S ecific A Blood 36.59 36.59 Payne,Thomas C. CMP(Comp Metabolic Panel $20.00 1 $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 Ryan,Christopher D. CMP(Comp Metabolic Panel $20.00 20.00 CBC Com Blood Count 18.13 18.13 Lipid Panel Blood 21.26 21.26 Venipuncture 3.14 3.14 Small Thomas D. CMP Com Metabolic Panel 20.00 $20.00 CBC(Comp Blood 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 07/27/16 Contino David M. CMP(Comp Metabolic Panel $20.00 $20.00 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 Holubik Steven W. 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 $3.1413.14 PSA-Prostate S ecific A Blood 36.59 36.59 Public Safety Medical - INVOICE o Public Safety Medical Invoice Date: 08/03/2016 _ 324 E. New York Street Invoice# 00-28831 E Suite 300 Terms: ✓ W Indianapolis, IN 46204 µ o Carmel Fire Department/CARMEFD I•- Denise Snyder, Budget&Accred Mgr m 2 Civic Square Carmel, IN 46032 Exclusively Serving Public Safety Professionals Since 1990. Date Employee Description AmountBalance Due Sombke Brad D. 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 Total Charges'- $2,133.40 Total Payments&Balance Due->1 $0.00 $2,133.40 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.