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CITY OF CARMEL, INDIANA VENDOR: 00350364 CHECK AMOUNT: S**"**2,560.55*
ONE CIVIC SQUARE PUBLIC SAFETY MEDICAL SERVICES CARMEL, INDIANA 46032 324 E NEW YORK ST SUITE 300 CHECK NUMBER: 306159
INDIANAPOLIS IN 46204 CHECK DATE: 12/12/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4340701 00-29578 800.66 MEDICAL EXAM FEES
1110 4340701 29488 800.66 MEDICAL EXAM FEES
1120 4340701 29526 248.40 MEDICAL EXAM FEES
1120 4340701 29577 710.83 MEDICAL EXAM FEES
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Public Safety Medical - INVOICE
o Public Safety Medical Invoice Date: 11/23/2016 _J ^
324 E. New York Street Invoice# 00-29526
E Suite 300 Terms: ,
lz Indianapolis, IN 46204
e Y
C Carmel Fire Department/CARMEFD
H Denise Snyder, Budget&Accred Mgr
m 2 Civic Square(PO#24831)
Carmel, IN 46032
Exclusively Serving Public Safety Professionals Since 1990.
Date Employee Description Amount Balance Due
11/14/1 Hoffman.Matthew F. M mt-M I i- i i lin M eetina $165.60 $165.60
11/18/16 Brandt Gary D. Repeat Vision-Acuity $0.00 $0.00
Audiometry $0.00 $0.00
Payne,Tom Fitness For Duty Exam Initial Level 1 82.80 $82.80
Total Charges-> $248.40
Total Payments&Balance Due-> $0.00 $248.40
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.
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Public Safety Medical - INVOICE
t°- Public Safety Medical Invoice Date: 12/02/2016
324 E. New York Street Invoice# 00-29577
E Suite 300 Terms:
W Indianapolis, IN 46204
C Carmel Fire Department/CARMEFD
1- Denise Snyder, Budget&Accred Mgr
m 2 Civic Square(PO#24831)
Carmel, IN 46032
Exclusively Serving Public Safety Professionals Since 1990.
Date Employee Description Amount Balance Due
11121/16 Cummins,Frank C. Comp hensiveh i l $102.46 1 .4
Respirator/Medical Review $16.73 $16.7
OnMed Program $0.00 $0.00
Health Risk Appraisal Motivation 0.00 $0.00
Treadmill-Submax $159.90 $159.90
Body Fat Test-BIA Bio-Elec Imp Anal 14.64 $14.
Chest X-Ray-PA/LAT Di ital 62.73 $62.7
Vital Signs-HT WT BP P R $0.00 $0.00
Vision-Acuity 27.18 $27.1
PFT-Pulmonary Function Test $34.50 $34.5
Audiometry 14. 14.
EKG W/Intero $20.91 $20.91
Urinalysis-Dipstick 4 .14
Steele JeffreyA. No Show Fee
11/23/16 Steele Jeffrey A. Treadmill-Submax $159.90 $159.90
Body Fat Test-BIA Bio-Elec Imp Anal 14.64 $14.
Chest X-Ray-PA/LAT(Digital) 62.73 $62.73
Respirator/Medical Review $16.73 $16.7
OnMed Pro ram $0.00 $0.00
Health Risk Appraisal Motivation 0.00 $0.00
Total Charges->1 $750.83
Total Payments&Balance Due->1 $0.00 3
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.