The URL can be used to link to this page

Home My WebLink About302934 09/12/16 CITY OF CARMEL, INDIANA VENDOR: 367222 4 d 31 ONE CIVIC SQUARE IU HEALTH WORKPLACE SERVICES LLCCHECK AMOUNT: $****72,689.77* CARMEL, INDIANA 46032 2046 RELIABLE PKWY CHECK NUMBER: 302934 CHICAGO IL 60686-0020 CHECK DATE: 09/12/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1201 4358800 751520 135.00 TESTING FEES 301 5023990 751521 75.00 OTHER EXPENSES 301 5023990 751604 4,374.16 OTHER EXPENSES 1205 4347500 751605 729.60 GENERAL INSURANCE 301 5023990 751606 43,323.40 OTHER EXPENSES 301 5023990 751894 22,142.95 OTHER EXPENSES 301 5023990 752078 1,909.66 OTHER EXPENSES r VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) IU HEALTH WORKPLACE SERVICES LLC ALLOWED 20 ACCOUNTS PAYABLE VOUCHER 2046 RELIABLE PKWY IN SUM OF$ 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. $71,825.17 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 751521 50-239.90 $75.00 1 hereby certify that the attached invoice(s),or 8/31/16 751521 Aug Onsite Wellness UDS $75.00 301 301 301 301 752078 50-239.90 $1,909.66 bill(s)is(are)true and correct and that the 8/31/16 752078 Aug Onsite Supply Billing $1,909.66 301 301 materials or services itemized thereon for 301 301 751894 50-239.90 $22,142.95 8/31/16 751604 Aug Onsite Fees $4,374.16 301 301 which charge is made were ordered and 301 301 751606 50-239.90 $43,323.40 received except 8/31/16 751606 Aug Onsite Staff Time $43,323.40 301 301 301 301 751604 50-239.90 $4,374.16 8/31/16 751894 Aug Onsite Misc $22,142.95 301 301 301 301 Tuesday,September 06,2016 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 Health Workplace Services, LLC 3�\ 950 North Meridian Street. Suite 950 (City of Carmel) Indianapolis, IN 46204 :317-963-1535. Tax ID# 20-0994452 . Invoice August 31.; 2016 Bill•to:. Barbara Iamb For: . City.of Carmel Onsite City of Carmel Onsite . Wellness.LIDS/August;2016 1 Civic Square . Carmel,IN 46032- Inv'ice#: 751521 . . . Service Date Description Care' RcipAdiust' Balance 08/01/2016 Quick,Read UDS/6panel includes 1.00 15.00 15.00 kit INCLUDE INVOICE#011 CHECK J. r U Cu I Clerk reas urer Cut and return with navment Indiana University HealthWorkplace S&vices,LLC 950 North Meridian Street. . Suite 950:(City of Carmel), Ind'ianapolis,'IN 46204: 3117-96371535. Tak ID#'2Q-0994452 ; Invoice Augus t 31.; 2016 . . Bill to:. Barbara Lamb . For:'. City of Carmel-.Onsite City of Carmel--Onsite' Supply BillingYAug.2016 1 Civic Square . Carmel,IN.46032 Invoice# 752078. . Service Date Description Quantity Charae Recei Ad'us Balance. 08/01/2016 Onsite Operating Supplies. . 1.00' 1,909.66. 1909.66 August 2016 Supplies CITXCARO Invoice#. 752078 Balance Due: 1909.66 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF'INV OICE DATE-PLEASE INCLUDE . INVOICE.#ON CHECK Sflt `ed' o s b SEPIA 6 .2016 .. . . C . dOk Treasurer Indiana University Health Workplace Services,LLC 950 North Meridian'.Street . Suite'950:{Cit 'of Carmel). . . Indianapolis IN46204 . 317- - • 963.1535 .: Tax ID# 20-0994452 Invoice August'31, 2016 . Bill to:. Barbara Lamb . For: . City of Carmel-Onsite* City of Carmel-.Onsite Misc.Orisite/August 2016 1 Civic Square Carmel,-IN 46.032 Invoice#: 751894 Service Date Description uanti Charge Recei Adjust Balance 06/30/2016 . Young:at Heart Mail-Iris 1.00. 2,069.25'. 2069.25 07/01/2016 Onsite Lab Charges .1.00. 4,09848: 4098.48 Ju1y2016 Labs .07/01/2016, Young at Heart Mail-Ins L.Q.0 $18:29 51'8.29 07/17/2016 Young at Heart Mail-Iris 1.00 1,31718. 1312.18 07/19/2016' Young at Heart Clinic Meds 1.00, . . 1,158:58 1158.58 07/28/2016 _ Young at Heart Clinic Meds: . 1.00' 114:26, 114.26 07/31/2016 Young at Heart Mail-Iris 1.00 4,750:52 4750.52 08/01/2016. Young at Heart Clinic Meds 1.00 '1,221;54' 1221.54 08/01/2016 _ Young at Heart Mail-Iris L.00, 1,681.14 1681.14 08/14/2016 Young at Heart Mail-Ins 1.00 3,5.9138: '3591.38 08/18/2016 Young at Heart Clinic Meds 1.00, 1,622:33' 1622.33 CITYCARO Invoice#.751894 Balance Due:. 22142.95 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE.-:PLEASE INCLUDE' INVOICE#.ON. CHECK: � ;�e SEP: 0 6 2016 Indiana University Health Workplace Services,LLC 3�l 950 North Meridian Street Suite 950 (City of Carmel) Indianapolis, IN 46204 317-963-1535 Tax I D# 20-0994452 Invoice August 31, 2016 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Staff Time/August 2016 1 Civic Square Carmel,IN 46032- Invoice# 751606 Service Date Description Quant! Charae Recei Ad"us Balance 08/01/2016 M.A.Staff Time 9.25 259.00 259.00 Kimberly Pride 08/01/2016 R.N.Staff Time 9.25 573.50 573.50 Mareesa Martin 08/01/2016 Health Coach Staff Time 3.00 192.00 192.00 Marissa Grant 08/01/2016 N.P.Staff Time 4.00 450.72 450.72 Tina Nitsos 08/01/2016 MD Staff Time 5.00 875.00 875.00 Dr.Fagan 08/02/2016 M.A.Staff Time 6.50 182.00 182.00 Kimberly Pride 08/02/2016 R.N.Staff Time 7.00 434.00 434.00 Mareesa Martin 08/02/2016 MD Staff Time 6.00 1,050.00 1050.00 Dr.Fagan 08/03/2016 M.A.Staff Time 9.50 266.00 266.00 Kimberly Pride 08/03/2016 R.N.Staff Time 9.50 589.00 589.00 Mareesa Martin 08/03/2016 N.P.Staff Time 4.50 507.06 507.06 Tina Nitsos 08/03/2016 MD Staff Time 5.00 875.00 875.00 Dr.Fagan 08/04/2016 M.A.Staff Time 5.25 147.00 147.00 Kimberly Pride 08/04/2016 R.N.Staff Time 6.50 . 403.00 403.00 Mareesa Martin 08/04/2016 Health Coach Staff Time 5.50 352.00 352.00 Marissa Grant 08/04/2016 MD Staff Time 4.00 700.00 700.00 Dr.Fagan Invoice# 751606(continued)page 2 Service Date DescHption Quanti Charge Recei A Balance 08/05/2016 M.A.Staff Time 6.00 168.00 168.00 Kimberly Pride 08/05/2016 R.N.Staff Time 7.00 434.00 434.00 Mareesa Martin 08/05/2016 Health Coach Staff Time 3.50 224.00 224.00 Marissa Grant 08/05/2016 N.P.Staff Time : 5.00 563.40 563.40 Tina Nitsos 08/08/2016 Health Coach Staff Time 2.50 160.00 160.00 Marissa Grant 08/08/2016 N.P.Staff Time 4.00 450.72 450.72 Tina Nitsos 08/08/2016 M.A.Staff Time 9.50 266.00 266.00 Kimberly Pride 08/08/2016 R.N.Staff Time 9.50 589.00 589.00 Mareesa Martin 08/08/2016 MD Staff Time 5.00 875.00 875.00 Dr.Fagan 08/09/2016 M.A.Staff Time 6.00 168.00 168.00 Kimberly Pride 08/09/2016 R.N.Staff Time 7.50 465.00 465.00 Mareesa Martin 08/09/2016 MD Staff Time 6.00 1,050.00 1050.00 Dr.Fagan 08/10/2016 N.P.Staff Time 5.00 563.40 563.40 Tina Nitsos 08/10/2016 M.A.Staff Time 10.00 280.00 280.00 Kimberly Pride 08/10/2016 R.N.Staff Time 9.75 604.50 604.50 Mareesa Martin 08/10/2016 MD Staff Time 5.00 875.00 875.00 Dr.Fagan 08/11/2016 Health Coach Staff Time 5.00 320.00 320.00 Marissa Grant 08/11/2016 M.A.Staff Time 4.50 126.00 126.00 Kimberly Pride 08/11/2016 R.N.Staff Time 5.50 341.00 341.00 Mareesa Martin 08/11/2016 MD Staff Time 4.00 700.00 700.00 Dr.Fagan 08/12/2016 Health Coach Staff Time 4.50 288.00 288.00 Marissa Grant 08/12/2016 M.A.Staff Time 6.50 182.00 182.00 Kimberly Pride 08/12/2016 R.N.Staff Time 7.50 465.00 465.00 Mareesa Martin 08/12/2016 MD Staff Time 5.00 875.00 875.00 ,Dr.Fagan Invoice# 751606(continued)page 3 Service Date DescriptionQuant!t Charge Receipt Adjust Balance 08/15/2016 MD Staff Time 5.00 875.00 875.00 Dr.Fagan 08/15/2016 Health Coach Staff Time 3.00 192.00 192.00 Marissa Grant 08/15/2016 N.P.Staff Time 4.50 507.06 507.06 Tina Nitsos 08/15/2016 M.A.Staff Time 9.50 266.00 266.00 Kimberly Pride 08/15/2016 R.N.Staff Time 9.50 589.00 589.00 Mareesa Martin 08/16/2016 MD Staff Time 6.00 1,050.00 1050.00 Dr.Fagan 08/16/2016 M.A.Staff Time 6.00 168.00 168.00 Kimberly Pride 08/16/2016 R.N.Staff Time 7.75 480.50 480.50 Mareesa Martin 08/17/2016 MD Staff Time 5.00 875.00 875.00 Dr.Fagan, 08/17/2016 N.P.Staff Time 4.00 450.72 450.72 Tina Nitsos 08/17/2016 M.A.Staff Time 9.00 252.00 252.00 Kimberly Pride 08/17/2016 R.N.Staff Time 9.50 589.00 589.00 Mareesa Martin 08/18/2016 MD Staff Time 4.00 700.00 700.00 Dr.Fagan 08/18/2016 Health Coach Staff Time 5.50 352.00 352.00 Marissa Grant 08/18/2016 M.A.Staff Time 5.00 140.00 140.00 Kimberly Pride 08/18/2016 R.N.Staff Time 5.50 341.00 341.00 Mareesa Martin 08/19/2016 MD Staff Time 5.00 875.00 875.00 Dr.Fagan 08/19/2016 Health Coach Staff Time 3.50 224.00 224.00 Marissa Grant 08/19/2016 M.A.Staff Time 6.00 168.00 168.00 Kimberly Pride 08/19/2016 R.N.Staff Time 6.75 418.50 418.50 Mareesa Martin 08/22/2016 N.P.Staff Time 4.00 450.72 450.72 Tina Nitsos 08/22/2016 MD Staff Time 5.00 875.00 875.00 Dr.Fagan 08/22/2016 Health Coach Staff Time 4.00 256.00 256.00 Marissa Grant 08/22/2016 M.A.Staff Time 9.50 266.00 266.00 Kimberly Pride Invoice# 751606(continued)page 4 Service Date Description Quanti Charge Receipt AdLs Balance 08/22/2016 R.N.Staff Time 9.50 589.00 589.00 Mareesa Martin 08/23/2016 MD Staff Time 6.00 1,050.00 1050.00 Dr.Fagan 08/23/2016 M.A.Staff Time 7.50 210.00 210.00 Kimberly Pride 08/23/2016 R.N.Staff Time 7.50 465.00 465.00 Mareesa Martin 08/24/2016 N.P.Staff Time 8.00 901.44 901.44 Tina Nitsos 08/24/2016 M.A.Staff Time 8.50 238.00 238.00 Kimberly Pride 08/24/2016 R.N.Staff Time 9.50 589.00 589.00 Mareesa Martin: 08/25/2016 MD Staff Time 4.00 700.00 700.00 Dr.Fagan 08/25/2016 Health Coach Staff Time 4.00 256.00 256.00 Marissa Grant 08/25/2016 M.A.Staff Time 4.50 126.00 126.00 Kimberly Pride 08/25/2016 R.N.Staff Time 5.50 341.00 341.00 Mareesa Martin 08/26/2016 MD Staff Time 5.00 875.00 875.00 Dr.Fagan 08/26/2016 Health Coach Staff Time 4.00 256.00 256.00 Marissa Grant 08/26/2016 M.A.Staff Time 6.50 182.00 182.00 Kimberly Pride 08/26/2016 R.N.Staff Time 7.00 434.00 434.00 Mareesa Martin 08/29/2016 N.P.Staff Time 4.00 450.72 450.72 Tina Nitsos 08/29/2016 MD Staff Time 5.00 875.00 875.00 Dr.Fagan 08/29/2016 Health Coach Staff Time 4.00 256.00 256.00 Marissa Grant 08/29/2016 M.A.Staff Time 9.50 266.00 266.00 Kimberly Pride 08/29/2016 R.N.Staff Time 9.50 589.00 589.00 Mareesa Martin 08/30/2016 MD Staff Time 6.00 1,050.00 1050.00 Dr.Fagan 08/30/2016 M.A.Staff Time 6.00 168.00 168.00 Kimberly Pride 08/30/2016 R.N.Staff Time 7.50 465.00 465.00 Mareesa Martin 08/31/2016 N.P.Staff Time 8.00 901.44 901.44 Tina Nitsos Invoice# 751606,(continued)page 5 Service Date Dekdotion Quanti Care Receipt d'us Balance 08/31/2016 M.A.Staff Time 9.00 252.00 . 252.00 Ximberly Pride 08/31/2016 . R.N.Staff Time 9.50 589.00 589.00 Mareesa Martin CITYCARO Invoice# 751606 Balance Due: 43323.40 'MAKE PAYMENT TO THE BELOW ADDRESS WITHIN,30 DAYS OF INVOICE DATE-.PLEASE INCLUDE INVOICE#ON CHECK -ted To SEP 0 6.Z016' . Clerk Treasurer a ment Indiana University Health Workplace Services, LLC 950 North Meridian Street 3�1 Suite 950 Indianapolis,:IN 46204. . .: 317=963-1535 Tax ID# 20-0994452 Invoice. . August31.,.2016 Bill to: Barbara Lamb For: City-of Carmel-Onsite City of Carmel-Onsite Onsite Fee's/.August 2016 1 Civic Square Carmel,IN 46032 Invoice#: 751604 Service Date Description ua ti Cliarae Recei Ad"us Balance ' 08/01/2016 City of Carmel Sports Performance 1.00 1,800:00 1800.00 Lease 08/01/2016 City of Carmel Clinic Build Out 1.00 2,574.16 2574.16 CITYCARO Invoice#.751604 Balance Due: 4374.16 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK Submitted To cu 'nite To SEP 06 2016 l � � �rer` ith payment 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. $135.00 Payee ON ACCOUNT OF APPROPRIATION FOR Purchase Order# Human Resources Terms Date Due -71 PO# ACCT# DATE INVOICE# DESCRIPTION DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT 751520 43-588.00 $135.00 1 hereby certify that the attached invoice(s),or 8/31/16 751520 Aug Onsite Occupational $135.00 1201 101 1201 101 bill(s)is(are)true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except Tuesday, September 06,2016 1 hereby certify that the attached invoice(s),or bill(s),is(are)true and correct and I have audited same in accordance with IC 5-11-10-1.6 20 Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer 'Indiana University.Health Workplace Services, LLC 950 North-Meridian Street . • Suite 950.(City of Carmel Indianapolis, IN 46204: . .: 317-96371535. . Tak ID#'.20-0994452 . Invoice " August 31, 2016. ,., Bill to:: Barbara Lamb For: . .City.of Carmel .Onsite City of Carmel Onsite' Occwi tional/August 2016 1 Civic Square Carmel,IN 46032 Invoice#: 75.1520 Service Date Descriptionuanti Charge Recei d'us ABalance 08/08/2016" Quick Read UDS/6panel includes' 1.00 1.5:00. 1.5.00 kit 15.00 kit In . voice# 751520(continued)page 2 Service Date Description INVOICE#."ON CHECK � fi�� 'o SEP 0 6'2016 . . Clerk Treasurer VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) IU HEALTH WORKPLACE SERVICES LLC ALLOWED 20 ACCOUNTS PAYABLE VOUCHER 2046 RELIABLE PKWY IN SUM OF$ 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. $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 751605 43-475.00 $729.60 1 hereby certify that the attached invoice(s),or 8/31/16 751605 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 is made were ordered and received except Tuesday,September 06,2016 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 20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer Indiana University Health Workplace Services,LLC '725 950 North Meridian Street Suite 950'(City of Carmel). zJS.: Indianapolis, IN 46204 317-96371535 Tax ID# 20-0994452 Invoice August 31.,.2016 Bill to:. Barbara Lamb For: City-of Carmel-Onsite .City of Carmel-Onsite EAP Services/August 2016 1 Civic Square Carmel,.IN 46032- Invoice' #: 751605 Service Date Description, Quanti Charge Receip Ad'us Balance 08/01/2016 EAP Services 608.0:0: 729:60 729.60 CITYCARO Invoice# 751605 Balance Due: 729.60 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON.CHECK Submitted]To SEP 0 6 2016 C Clerk Treasurer l(q r......,a.,e.........:..........,e.,.