307276 1/20/17 (9)
CITY OF CARMEL, INDIANA VENDOR: 367222HECK AMOUNT: $****54,969.07ONE CIVIC SQUARE IU HEALTH WORKPLACE SERVICES LLCC
CARMEL, INDIANA 46032 2046 RELIABLE PKWYCHECK NUMBER: 307276
CHICAGO IL 60686-0020 CHECK DATE: 01/20/17
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1201 4358800 754151 105.00 TESTING FEES
301 5023990 754154 4,374.16 OTHER EXPENSES
1205 4347500 754155 744.00 GENERAL INSURANCE
301 5023990 754332 31,589.63 OTHER EXPENSES
301 5023990 754566 151725.34 OTHER EXPENSES
301 5023990 754674 2,430.94 OTHER EXPENSES
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S5 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
December 31, 2016
Bill to: Barbara Lamb For: City of Carmel-Onsite
City of Carmel-Onsite Occupational/Dec.2016
1 Civic Square
Carmel,IN 46032-
Invoice# 754151
Service Date Description Quantity Charoe Bece1pS A" Balance
12/28/2016 Quick Read UDS/6panel includes 1.00 15.00 15.00
kit
15.00
kit
FSubmitted To
10 2017
Clerk Treas=urer
Invoice# 754151 (continued)page 2
Service Date Description Quantity Charge ReceipBalance
15.00
CITYCARO Invoice# 754151 Balance Due: 105.00
MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE
INVOICE#ON CHECK
w Cut and return with payment
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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
December 31, 2016
Bill to: Barbara Lamb For: City of Carmel-Onsite
City of Carmel-Onsite Staff Time/Dec. 2016
1 Civic Square
Carmel,IN 46032-
Invoice# 754332
Service Date Description Quantity Charrge Receipt Adiust Balance
12/01/2016 R.N.Staff Time 6.50 403.00 403.00
Mareesa Martin
12/01/2016 MD Staff Time 4.00 700.00 700.00
Dr.Fagan
12/01/2016 M.A.Staff Time 5.25 147.00 147.00
Kimberly Pride
12/01/2016 R.N.Staff Time 5.00 310.00 310.00
Mareesa Martin
12/01/2016 Health Coach Staff Time 5.00 320.00 320.00
Marissa Grant
12/02/2016 MD Staff Time 5.00 875.00 875.00
Dr.Fagan
12/02/2016 M.A.Staff Time 7.00 196.00 196.00
Kimberly Pride
12/02/2016 R.N.Staff Time 5.50 341.00 341.00
Mareesa Martin
12/02/2016 Health Coach Staff Time 3.00 192.00 192.00
Marissa Grant
12/05/2016 MD Staff Time 5.00 875.00 875.00
Dr.Fagan
12/05/2016 N.P.Staff Time 4.75 535.23 535.23
Tina Nitsos
12/05/2016 M.A.Staff Time 9.00 252.00 252.00
Kimberly Pride
12/05/2016 R.N.Staff Time 9.75 604.50 604.50
Mareesa Martin
12/05/2016 Health Coach Staff Time 3.00 192.00 192.00
Marissa Grant
12/06/2016 MD Staff Time 6.00 1,050.00 1050.00
Dr.Fagan
12/06/2016 M.A.Staff Time 7.00 196.00 196.00
Kimberly Pride
Submitted To
JAN 10 2017
Clerk Treasurer
Invoice# 754332(continued)page 2
Service Date Description Quantity Charge Receipt Adiust Balance
12/06/2016 R.N.Staff Time 7.00 434.00 434.00
Mareesa Martin
12/07/2016 N.P.Staff Time 8.50 957.78 957.78
Tina Nitsos
12/07/2016 M.A.Staff Time 8.75 245.00 245.00
Kimberly Pride
12/07/2016 R.N.Staff Time 9.75 604.50 604.50
Mareesa Martin
12/08/2016 MD Staff Time 4.00 700.00 700.00
Dr.Fagan
12/08/2016 M.A.Staff Time 4.50 126.00 126.00
Kimberly Pride
12/08/2016 R.N.Staff Time 4.75 294.50 294.50
Mareesa Martin
12/08/2016 Health Coach Staff Time 4.00 256.00 256.00
Marissa Grant
12/09/2016 MD Staff Time 5.00 875.00 875.00
Dr.Fagan
12/09/2016 M.A.Staff Time 6.50 182.00 182.00
Kimberly Pride
12/09/2016 R.N.Staff Time 6.25 387.50 387.50
Mareesa Martin
12/09/2016 Health Coach Staff Time 5.00 320.00 320.00
Marissa Grant
12/12/2016 N.P.Staff Time 4.50 507.06 507.06
Tina Nitsos
12/12/2016 Health Coach Staff Time 2.50 160.00 160.00
Marissa Grant
12/12/2016 M.A.Staff Time 9.50 266.00 266.00
Kimberly Pride
12/12/2016 R.N.Staff Time 9.25 573.50 573.50
Mareesa Martin
12/13/2016 MD Staff Time 6.00 1,050.00 1050.00
Dr.Fagan
12/13/2016 M.A.Staff Time 6.75 189.00 189.00
Kimberly Pride
12/13/2016 R.N.Staff Time 6.75 418.50 418.50
Mareesa Martin
12/14/2016 M.A.Staff Time 9.00 252.00 252.00
Kimberly Pride
12/14/2016 R.N.Staff Time 9.50 589.00 589.00
Mareesa Martin
12/14/2016 N.P.Staff Time 8.50 957.78 957.78
Tina Nitsos
12/15/2016 MD Staff Time 4.00 700.00 700.00
Dr.Fagan
12/15/2016 Health Coach Staff Time 5.00 320.00 320.00
Marissa Grant
Invoice# 754332(continued)page 3
Service Date Description Quantity Charge Receipt Adiust Balance
12/15/2016 M.A.Staff Time 5.00 140.00 140.00
Kimberly Pride
12/15/2016 R.N.Staff Time 5.00 310.00 310.00
Mareesa Martin
12/16/2016 MD Staff Time 5.00 875.00 875.00
Dr.Fagan
12/16/2016 R.N.Staff Time 6.50 403.00 403.00
Mareesa Martin
12/16/2016 M.A.Staff Time 6.25 175.00 175.00
Kimberly Pride
12/16/2016 Health Coach Staff Time 5.00 320.00 320.00
Marissa Grant
12/19/2016 M.A.Staff Time 8.75 245.00 245.00
David Moran
12/19/2016 N.P.Staff Time 4.50 507.06 507.06
Tina Nitsos
12/19/2016 Health Coach Staff Time 2.50 160.00 160.00
Marissa Grant
12/19/2016 R.N.Staff Time 8.00 496.00 496.00
Mareesa Martin
12/20/2016 MD Staff Time 6.00 1,050.00 1050.00
Dr.Fagan
12/20/2016 R.N.Staff Time 6.50 403.00 403.00
Mareesa Martin
12/20/2016 M.A.Staff Time 7.25 203.00 203.00
Kimberly Pride
12/21/2016 M.A.Staff Time 9.50 266.00 266.00
Kimberly Pride
12/21/2016 R.N.Staff Time 9.25 573.50 573.50
Mareesa Martin
12/21/2016 N.P.Staff Time 8.50 957.78 957.78
Tina Nitsos
12/22/2016 MD Staff Time 4.00 700.00 700.00
Dr.Fagan
12/22/2016 R.N.Staff Time 5.00 310.00 310.00
Mareesa Martin
12/22/2016 M.A.Staff Time 6.25 175.00 175.00
Kimberly Pride
12/27/2016 M.A.Staff Time 6.00 168.00 168.00
Kimberly Pride
12/27/2016 R.N.Staff Time 6.00 372.00 372.00
Mareesa Martin
12/27/2016 MD Staff Time 6.00 1,050.00 1050.00
Dr.Fagan
12/28/2016 N.P.Staff Time 8.00 901.44 901.44
Tina Nitsos
12/28/2016 M.A.Staff Time 8.50 238.00 238.00
Kimberly Pride
Invoice# 754332(continued)page 4
Service Date Description Quantity Charge Receipt Adiust Balance
12/28/2016 R.N.Staff Time 8.50 527.00 527.00
Mareesa Martin
12/29/2016 M.A.Staff Time 4.00 112.00 112.00
Kimberly Pride
12/29/2016 R.N.Staff Time 4.00 248.00 248.00
Mareesa Martin
12/29/2016 MD Staff Time 4.00 700.00 700.00
Dr.Fagan
12/30/2016 M.A.Staff Time 5.00 140.00 140.00
Kimberly Pride
12/30/2016 R.N.Staff Time 5.00 310.00 310.00
Mareesa Martin
CITYCARO Invoice# 754332 Balance Due: 31589.63
MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE
INVOICE#ON CHECK
Cut and return with payment
Indiana University Health Workplace Services, LLC
950 North Meridian Street
Suite 950
Indianapolis, IN 46204
317-963-1535
Tax ID# 20-0994452
Invoice
December 31, 2016
Bill to: Barbara Lamb For: City of Carmel-Onsite
City of Carmel-Onsite Onsite Fee's/Dec.2016
1 Civic Square
Carmel,IN 46032-
Invoice# 754154
Service Date Description Quantity Charge Receipt A" Balance
12/01/2016 City of Carmel Sports Performance 1.00 1,800.00 1800.00
Lease
12/01/2016 City of Carmel Clinic Build Out 1.00 2,574.16 2574.16
CITYCARO Invoice# 754154 Balance Due: 4374.16
MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE
INVOICE#ON CHECK
Submitted To
JAN 10 2017
Clerk Treasurer
Cut and return with payment
_j 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
December 31, 2016
Bill to: Barbara Lamb For: City of Carmel-Onsite
City of Carmel-Onsite Misc.Onsite/Dec.2016
1 Civic Square
Carmel,IN 46032-
Invoice# 754566
Service Date Description Quantity Charae Receipt A&M Balance
10/31/2016 Young at Heart Mail-Ins 1.00 3,148.94 3148.94
11/01/2016 Onsite Lab Charges 1.00 1,954.12 1954.12
November 2016 Labs
11/09/2016 Young at Heart Clinic Meds 1.00 639.01 639.01
11/13/2016 Young at Heart Mail-Ins 1.00 4,280.21 4280.21
11/18/2016 Young at Heart Clinic Meds 1.00 896.28 896.28
11/20/2016 Young at Heart Mail-Ins 1.00 4,240.92 4240.92
12/02/2016 Young at Heart Clinic Meds 1.00 565.86 565.86
CITYCARO Invoice# 754566 Balance Due: 15725.34
MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE
INVOICE#ON CHECK
Submitted To
JAN 10 2017
Clerk Treasurer
Cut and return with payment
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
December 31, 2016
Bill to: Barbara Lamb For: City of Carmel-Onsite
City of Carmel-Onsite Supply Billing/Dec 2016
1 Civic Square
Carmel,IN 46032-
Invoice# 754674
Service Date Description Quantity Charge Receipt A&9 Balance
12/01/2016 Onsite Operating Supplies 1.00 2,430.94 2430.94
December 2016 Supplies
CITYCARO Invoice# 754674 Balance Due: 2430.94
MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE
INVOICE#ON CHECK
Submitted To
JAN 10 2017
Clerk Treasturer
�.r Cut and return with payment
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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
December 31, 2016
Bill to: Barbara Lamb For: City of Carmel-Onsite
City of Carmel-Onsite EAP Services/Dec.2016
1 Civic Square
Carmel,IN 46032-
Invoice# 754155
Service Date Description Quantity Charge Receipt AMW )Balance
12/01/2016 EAP Services 620.00 744.00 744.00
CITYCARO Invoice# 754155 Balance Due: 744.00
MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE
INVOICE#ON CHECK
Submitted To
JAN 10 2017
Clerk Treasurer
w Cut and return with payment