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308936 03/07/17
�..W s+.w� CITY OF CARMEL, INDIANA VENDOR: 364990 ONE CIVIC SQUARE C H C WELLNESS CHECK AMOUNT: $ 160.00 i ,� CARMEL, INDIANA 46032 5440 N CUMBERLAND AVE#225 CHECK NUMBER: 308936 �w�raN. CHICAGO IL 60656 CHECK DATE: 03/07/17 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 301 5023990 C3381 160.00 OTHER EXPENSES n n « n « « 0 -N O I t Im O 0 CL �# > 2 ° 0 ^ n q m m C: m } \ 2 k q k k / % § 0 o S $ r- $ 0 E 9 0 k 4t ƒ ƒ -n k 9 2 § k k m $ -n / 3 / / § ) k \ § §a -0 Cil m / k ^ 4t CL a- X D z § 7 2 ° -/ > O� \ \ k 8 Z | Er > z - E ( ƒ ƒ Cl) § FL k = § K H CD 03 a s -n o E Q a 3 a - E E § 2 f f 2 § 2 ( $ I + - 7 k CC) / $ ( 8 & q + a " C n @ � k C? CL 2 \/ / / } k C © , 3 § o o g _kƒ j mo f ƒ & ) PL § ( 3 CD D �� - P \ 8 = c / a ° 0 8 9 S § Q E ] �w � § 2k ƒ Z C a ) J \ CL 0 Z # \C) =r \ \ C/)�< % / fƒ :3 \ q 0 > a * a D $o ) Q 7 66 § q > / § / { n 0 0 91) CD c f U) =r % ] i % J / c _ G m CD CD } } 02r M n B k 2 $ c§ C ] k ® z Z o } \ \ \ _ 2 ƒ 0 ) k } o - a 5440 N. Cumberland Ave.,Suite 225 INVOICE Clikago, IL 60656 TEU 847.640.4440 _ FAX: 847.4.37.2770 Invoice# C3381 —tel cv-v:'%v.chcw.com Date 7/12/2016 Ship 9/8/2016 Bill To Terms Due on receipt City of Carmel Attn:Barbara Lamb Rep Ron One Civic Street Carmel,IN 46032 Due Date 7/12/2016 Quantity Item Code Description Price Each Amount Wellness Screenings for All City of Carmel Employees- Follow Up Screenings 50 H&W-Company Health&Wellness-City of Carmel Water Operations-7/12/2016 80.00 4,000.00 132 H&W-Company Health&Wellness-City of Cannel City Hall -7/19/2016 80.00 10,560.00 8 H&W-Company Health&Wellness-City of Carmel.-Remote Ending-7/29/2016 80.00 640.00 Manual Blood Work Submitted 15 MBW Manual Blood Results Submitted-Remote Ending-7/29/2016 80.00 1,200.00 3 MBW Manual Blood Results Submitted-Remote Ending-8/31/2016 80.00 240.00 *Please refer to the attached Roster for a detailed breakdown of participants. Submilted To MAR 0 7 2017 *Another Invoice to tbllow after Remote Closes on 8/.31/2016 Clerk T easurer Thank you for your business. Invoice Total $16,640.00 PLEASE MAKE CHECK PAYABLE TO: CHC WELLNESS payments/Credits -$16,49000 REMITTANCE ADDRESS: 5440 NORTH CUMBERLAND AVE., SUITE 225 Balance due $1so,00 CHICAGO, IL 60656