HomeMy WebLinkAbout304235 10/19/16 (2) CITY OF CARMEL, INDIANA VENDOR: 367222
ONE CIVIC SQUARE IU HEALTH WORKPLACE SERVICES LLCCHECK AMOUNT: $...«47,878.42'
CARMEL, INDIANA 46032 2046 RELIABLE PKWY CHECK NUMBER: 304235
CHICAGO IL 606860020 CHECK DATE: 10/19/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
301 5023990 752169 4,374.16 OTHER EXPENSES
301 5023990 752200 36,078.22 OTHER EXPENSES
1201 4358800 752310 754.00 TESTING FEES
1205 4347500 752606 729.60 GENERAL INSURANCE
301 5023990 752674 4,992.75 OTHER EXPENSES
301 5023990 752684 949.69 OTHER EXPENSES
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Invoice# 752200(continued)page 4
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Service Date Descdntlon uanti ChcReceint Adjust Balance
09/26/2016 Health Coach Staff Time 3.00 192.00 192.00
Marissa Grant
09/27/2016 M.A.Staff Time 7.00 196.00 196.00
Kimberly Pride
09/27/2016 R.N.Staff Time 7.00 434.00 434.00
Mareesa Map-tin
09/27/2016 MD Staff Time 6.00 1,050.00 1050.00
Dr.Fagan
09/28/2016 M.A.Staff Time 9.25 259.00 259.00
Kimberly Pride
09/2812016 R.N.Staff Time 9.25 573.50 573.50
Mareesa Martin
09/28/2016 N.P.Staff Time 8.50 957.78 957.78
Tina Nitsos
09/29/2016 M.A.Staff Time 4.50 126.00 126.00
Kimberly Pride
09129/2016 R.N.Staff Time 5.00 310.00 310.00
Mareesa Martin
09/29/2016 MD Staff Time 4.00 700.00 700.00
Dr.Fagan
09/29/2016 Health Coach Staff Time 6.00 384.00 384.00
Marissa Grant
09/30/2016 M.A.Staff Time 5.25 147.00 147.00
Kimberly Pride -
09/30/2016 R.N.Staff Time 5.25 325.50 325.50
Mareesa Martin
09/30/2016 MD Staff Time 5.00 875.00 875.00
Dr.Fagan
CITYCARO Invoice# 752200 Balance Due: 36.078.22'
MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE
INVOICE#ON CHECK
Indiana University Health Workplace Services, LLC
950 North Meridian Street
-- Suite 950
Indianapolis, IN 46204
317-963-1535
Tax ID# 20-0994452
Invoice
September 30,2016
Bill to: Barbara Lamb For: City of Carmel-Onsite
City of Carmel-Onsite Onsite Fee's/Sept.2016
1 Civic Square
Carmel,IN 46032-
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Invoice# 752169
Service Date Description Quenti Charge Receipt Adjust Balance
09/01/2016 City of Carmel Sports Performance 1.00 1,800.00 1800.00
Lease
09/01/2016 City of Carmel Clinic Build Out 1.00 2,574.16 2574.16
CITYCARO Invoice# 752169 Balance Due: 4374.16
MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE
INVOICE#ON CHECK
Su b m!tte d To
OCT 0 4 2016
Clea T reasug er
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
September 30,2016
Bill to: Barbara Lamb For: City of Carmel-Onsite
City of Carmel-Onsite Misc.Onsite/Sept.2016
1 Civic Square
Carmel,IN 46032-
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Invoice# 752674
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Service Date Description Quan Charge Receipt A&U-SI Balance
08/01/2016 Onsite Lab Charges 1.00 3,653.42 3653.42
August 2016 Labs
09/06/2016 Young at Heart Clinic Meds 1.00 1,189.40 1189.40
09/07/2016 Young at Heart Clinic Meds 1.00 149.93 149.93
CITYCARO Invoice# 752674 Balance Due: 4992.75
MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE
INVOICE#ON CHECK
Submitted To
OCT 04 2016
(Dierk Treasurer
6E ove cha ged ssparat ch c to IU
I Health o IU Hearth vrorkplac
dept : invoice#
$:46,394.82. . : : 301 75�2�200 752169 752674 752684
$. 729.60 1205 752606 :
$.: 754.00. 1201 752310
$ 4+7,8r7�8.42 total of check to send to IU Health Workplace Services