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Home My WebLink About305197 11/14/16 o CITY OF CARMEL, INDIANA VENDOR: 367222 ONE CIVIC SQUARE IU HEALTH WORKPLACE SERVICES LLCCHECK AMOUNT: S****64,418.92` CARMEL, INDIANA 46032 2046 RELIABLE PKWY CHECK NUMBER: 305197 CHICAGO IL 60686-0020 CHECK DATE: 11/14/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1201 4358800 752858 75.00 TESTING FEES 301 5023990 752956 4,374.16 OTHER EXPENSES 301 5023990 752957 37,971.04 OTHER EXPENSES 1205 4347500 752958 724.80 GENERAL INSURANCE 301 5023990 752959 18,585.64 OTHER EXPENSES 301 5023990 753387 2,688.28 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. $724.80 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 752958 43-475.00 $724.80 1 hereby certify that the attached invoice(s),or 10/31/16 752958 $724.80 1205 101 1205 101 bill(s)is(are)true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except Wednesday, November 02,2016 I hereby certify that the attached invoice(s),or bill(s),is(are)true and correct and I have audited same in accordance with IC 5-11-10-1.6 20 Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer Indiana University Health Workplace Services,LLC 950 North Meridian Street Suite 950 (City of Carmel) 2 Indianapolis, IN 46204 317-963-1535 Tax ID# 20-0994452 Invoice October 31, 2016 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite EAP Service/Oct.2016 1 Civic Square Carmel,IN 46032- Invoice# 752958 Service Date Description Quanti Charge Receipt Aw-u—st Balance 10/01/2016 EAP Services 604.00 724.80 724.80 CITYCARO Invoice# 752958 Balance Due: 724.80 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK :NOVSubmitted To 2016 Clereasurer VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) IU HEALTH WORKPLACE SERVICES LLC ALLOWED 20 ACCOUNTS PAYABLE VOUCHER 2046 RELIABLE PKWY IN SUM OF$ 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. $63,619.12 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 752957 50-239.90 $37,971.04 1 hereby certify that the attached invoice(s),or 10/31/16 753387 Onsite Supply Oct $2,688.28 301 301 301 301 752956 50-239.90 $4,374.16 bill(s)is(are)true and correct and that the 10/31/16 752959 Onsite Misc Oct $18,585.64 301 301 materials or services itemized thereon for 301 1 301 752959 50-239.90 $18,585.64 10/31/16 752956 Onsite Fee Oct $4,374.16 301 301 which charge is made were ordered and 301 301 753387 50-239.90 $2,688.28 received except 10/31/16 752957 Onsite Staff Time Oct $37,971.04 301 301 301 301 Wednesday, November 02,2016 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 5-11-10-1.6 120 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 jl 317-963-1535 Tax ID# 20-0994452 Invoice October 31, 2016 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Staff Time/Oct.2016 1 Civic Square Carmel,IN 46032- Invoice# 752957 Service Date Description Quanti Charge Recelp Ad'us Balance 10/03/2016 N.P.Staff Time 5.00 563.40 563.40 Sheryll Jeffers 10/03/2016 Health Coach Staff Time 2.00 128.00 128.00 Marissa Grant 10/03/2016 R.N.Staff Time 9.25 573.50 573.50 Mareesa Martin 10/03/2016 M.A.Staff Time 9.50 266.00 266.00 Kimberly Pride 10/03/2016 N.P.Staff Time 4.50 507.06 507.06 Tina Nitsos 10/04/2016 R.N.Staff Time 8.50 527.00 527.00 Mareesa Martin 10/04/2016 M.A.Staff Time 9.75 273.00 273.00 Kimberly Pride 10/04/2016 N.P.Staff Time 6.00 676.08 676.08 Tina Nitsos 10/05/2016 R.N.Staff Time 10.75 666.50 666.50 Mareesa Martin 10/05/2016 N.P.Staff Time 8.50 957.78 957.78 Tina Nitsos 10/06/2016 N.P.Staff Time 4.00 450.72 450.72 Joyce Fuss 10/06/2016 Health Coach Staff Time 5.50 352.00 352.00 Marissa Grant 10/06/2016 R.N.Staff Time 7.00 434.00 434.00 Mareesa Martin 10/06/2016 M.A.Staff Time 5.50 154.00 154.00 Kimberly Pride 10/07/2016 Health Coach Staff Time 4.50 288.00 288.00 Marissa Grant 10/07/2016 R.N.Staff Time 7.50 465.00 465.00 Mareesa Martin Submitted To NOV. 02 2016 Clerk Treasurer Invoice# 752957(continued)page 2 Service Date Description Quanti Charae Receipt Adiu-si Balance 10/07/2016 M.A.Staff Time 6.50 182.00 182.00 Kimberly Pride 10/07/2016 N.P.Staff Time 5.50 619.74 619.74 Tina Nitsos 10/10/2016 R.N.Staff Time 9.25 573.50 573.50 Mareesa Martin 10/10/2016 MD Staff Time 5.00 875.00 875.00 Dr.Fagan 10/10/2016 Health Coach Staff Time 3.00 192.00 192.00 Marissa Grant 10/10/2016 M.A.Staff Time 9.00 252.00 252.00 Kimberly Pride 10/10/2016 N.P.Staff Time 4.50 507.06 507.06 Tina Nitsos 10/11/2016 R.N.Staff Time 6.75 418.50 418.50 Mareesa Martin 10/11/2016 MD Staff Time 6.00 1,050.00 1050.00 Dr.Fagan 10/11/2016 M.A.Staff Time 6.00 168.00 168.00 Kimberly Pride 10/12/2016 R.N.Staff Time 9.75 604.50 604.50 Mareesa Martin 10/12/2016 M.A.Staff Time 10.00 280.00 280.00 Kimberly Pride 10/12/2016 N.P.Staff Time 9.50 1,070.46 1070.46 Tina Nitsos 10/13/2016 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin 10/13/2016 MD Staff Time 4.00 700.00 700.00 Dr.Fagan 10/13/2016 Health Coach Staff Time 4.00 256.00 256.00 Marissa Grant 10/13/2016 M.A.Staff Time 4.50 126.00 126.00 Kimberly Pride 10/14/2016 R.N.Staff Time 6.75 418.50 418.50 Mareesa Martin 10/14/2016 MD Staff Time 5.00 875.00 875.00 Dr.Fagan 10/14/2016 Health Coach Staff Time 5.50 352.00 352.00 Marissa Grant 10/14/2016 M.A.Staff Time 6.50 182.00 182.00 Kimberly Pride 10/17/2016 M.A.Staff Time 9.00 252.00 252.00 Kimberly Pride 10/17/2016 R.N.Staff Time 9.25 573.50 573.50 Mareesa Martin 10/17/2016 N.P.Staff Time 4.50 507.06 507.06 Tina Nitsos Invoice# 752957(continued)page 3 Service Date Description Quanti Charge Recei Ad"Us Balance 10/17/2016 Health Coach Staff Time 2.50 160.00 160.00 Marissa Grant 10/17/2016 MD Staff Time 5.00 875.00 875.00 Dr.Fagan 10/18/2016 M.A.Staff Time 6.00 168.00 168.00 Kimberly Pride 10/18/2016 R.N.Staff Time 7.50 465.00 465.00 Mareesa Martin 10/18/2016 MD Staff Time 6.00 1,050.00 1050.00 Dr.Fagan 10/19/2016 M.A.Staff Time 10.50 294.00 294.00 Kimberly Pride 10/19/2016 R.N.Staff Time 9.25 573.50 573.50 Mareesa Martin 10/19/2016 N.P.Staff Time 8.50 957.78 957.78 Tina Nitsos 10/20/2016 M.A.Staff Time 4.50 126.00 126.00 Kimberly Pride 10/20/2016 R.N.Staff Time 6.50 403.00 403.00 Mareesa Martin 10/20/2016 Health Coach Staff Time 6.00 384.00 384.00 Marissa Grant 10/20/2016 MD Staff Time 4.00 700.00 700.00 Dr.Fagan 10/21/2016 M.A.Staff Time 7.50 210.00 210.00 Kimberly Pride 10/21/2016 R.N.Staff Time 6.75 418.50 418.50 Mareesa Martin 10/21/2016 Health Coach Staff Time 4.00 256.00 256.00 Marissa Grant 10/21/2016 MD Staff Time 5.00 875.00 875.00 Dr.Fagan 10/24/2016 M.A.Staff Time 9.50 266.00 266.00 Kimberly Pride 10/24/2016 R.N.Staff Time 9.75 604.50 604.50 Mareesa Martin 10/24/2016 N.P.Staff Time 4.50 507.06 507.06 Tina Nitsos 10/24/2016 Health Coach Staff Time 2.00 128.00 128.00 Marissa Grant 10/24/2016 MD Staff Time 5.00 875.00 875.00 Dr.Fagan 10/25/2016 M.A.Staff Time 6.50 182.00 182.00 Kimberly Pride 10/25/2016 R.N.Staff Time 7.00 434.00 434.00 Mareesa Martin 10/25/2016 MD Staff Time 6.00 1,050.00 1050.00 Dr.Fagan Invoice# 752957(continued)page 4 Service Date Description . Quantily Charge Receipt Ad'us Balance 10/26/2016 M.A.Staff Time 10.50 294.00 294.00 Kimberly Pride 10/26/2016 R.N.Staff Time 10.00 620.00 620.00 Mareesa Martin 10/26/2016 N.P.Staff Time 8.50 957.78 957.78 Tina Nitsos 10/27/2016 M.A.Staff Time 4.50 126.00 126.00 Kimberly Pride 10/27/2016 R.N.Staff Time 5.00 310.00 310.00 Mareesa Martin 10/27/2016 Health Coach Staff Time 5.00 320.00 320.00 Marissa Grant 10/27/2016 MD Staff Time 4.00 700.00 700.00 Dr.Fagan 10/28/2016 M.A.Staff Time 6.00 168.00 168.00 Kimberly Pride 10/28/2016 R.N.Staff Time 6.25 387.50 387.50 Mareesa Martin 10/28/2016 Health Coach Staff Time 4.50 288.00 288.00 Marissa Grant 10/28/2016 MD Staff Time 5.00 875.00 875.00 Dr.Fagan 10/31/2016 M.A.Staff Time 9.00 252.00 252.00 Kimberly Pride 10/31/2016 R.N.Staff Time 9.25 573.50 573.50 Mareesa Martin 10/31/2016 N.P.Staff Time 4.50 507.06 507.06 Tina Nitsos 10/31/2016 Health Coach Staff Time 2.00 128.00 128.00 Marissa Grant 10/31/2016 MD Staff Time 5.00 875.00 875.00 Dr.Fagan CITYCARO Invoice# 752957 Balance Due: 37971.04 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK Submitted To bmi" d To NOV 02 2016 Clerk Tr asurer Indiana University Health Workplace Services,LLC 950 North Meridian Street �>> Suite 950 Indianapolis, IN 46204 317-963-1535 Tax ID# 20-0994452 Invoice October 31, 2016 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Onsite Fee's/Oct.2016 1 Civic Square Carmel,IN 46032- Invoice# 752956 Service Date DescriptionQuant! Charge Recei Ad"US Balance 10/01/2016 City of Carmel Sports Performance 1.00 1,800.00 1800.00 Lease 10/01/2016 City of Carmel Clinic Build Out 1.00 2,574.16 2574.16 CITYCARO Invoice# 752956 Balance Due: 4374.16 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK S Submitted NOV 0i2' 2 2016 C18Tnea �d�eo r 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 October 31, 2016 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Misc.Onsite/Oct.2016 1 Civic Square Carmel,IN 46032- Invoice# 752959 Service Date DescriptionQuant! Charge Recei Ad"US Balance 08/31/2016 Young at Heart Mail-Ins 1.00 7,922.40 7922.40 09/01/2016 Onsite Lab Charges 1.00 2,005.03 2005.03 September 2016 Labs 09/18/2016 Young at Heart Mail-Ins 1.00 1,960.57 1960.57 09/23/2016 Young at Heart Clinic Meds 1.00 586.40 586.40 09/30/2016 Young at Heart Mail-Ins 1.00 4,722.77 4722.77 09/30/2016 Video Visit 2.00 98.00 98.00 September 2016 Video Visits 10/03/2016 Young at Heart Clinic Meds 1.00 1,290.47 1290.47 CITYCARO Invoice# 752959 Balance Due: 18585.64 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK Submitted To NOV 0 2 2016 Clerk Treasurer 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 October 31, 2016 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Supply Billing/Oct.2016 1 Civic Square Carmel,IN 46032- Invoice# 753387 Service Date Description Quanti Charae Recei Aw-u—st Balance 10/01/2016 Onsite Operating Supplies 1.00 2,688.28 2688.28 October 2016 Supplies CITYCARO Invoice# 753387 Balance Due: 2688.28 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No:201(Rev.1995) ILI 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. $75.00 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 752858 43-588.00 $75.00 I hereby certify that the attached invoice(s),or 10/31/16 752858 $75.00 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 Wednesday, November 02,2016 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 SgS; 950 North Meridian Street Suite 950 (City of Carmel) Indianapolis, IN 46204 317-963-1535 Tax I D# 20-0994452 Invoice October 31, 2016 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Occupational/Oct.2016 1 Civic Square Carmel,IN 46032- Invoice# 752858 Service Date Description Quanti Charge Recelp Adjust Balance 10/28/2016 Quick Read UDS/6panel includes 1.00 15.00 15.00 kit 75.00 MAKE PAYMENT TO THE BELOW DRESS*WH 6 biYS OF OICE DATE-PLEASE INCLUDE INVOICE#ON CHECK clerk re surer