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Home My WebLink About311137 5/9/2017 4 us G�gMR F,;, t` CITY OF CARMEL, INDIANA VENDOR: 367222 ONE CIVIC SQUARE IU HEALTH WORKPLACE SERVICES LLCCHECK AMOUNT: $****63,772.04* y` ,°; CARMEL, INDIANA 46032 2046 0 6 RELIABLE PKWY W0020 CHECK NUMBER: 311137 F eN CHECK DATE: 05/09/17 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1201 4358800 756576 300.00 TESTING FEES 301 5023990 756620 20,348.67 OTHER EXPENSES 301 5023990 756621 4,374.16 OTHER EXPENSES 301 5023990 756622 36,112.26- OTHER EXPENSES 1205 4347500 756705 756.00 GENERAL INSURANCE 301 5023990 756706 1,268.95 - OTHER EXPENSES 301 5023990 756972 447.00 -� OTHER EXPENSES 301 5023990 756986 165.00/ OTHER EXPENSES v°, m O = A m 7 O a o o 0 0 0 - Z n m 0 C c n G)m r m o = m 0 mC) O O O O WCCNN Z Z � O M 0WWzrn rn rn rn rn O O OD mN NN O G r N ik 71 N N n N a 9 - C m o v m -0 o Cil 0 0 0 0 0cn cDi m m o (w0 fW0 f0 cp cW0 (O a : � < v o o o o o o :m It a. a C7 m U) OL o Z 0 Z EA N to W D -n O (D A IV W W _ OT 0 001 V OOD .pAD A N C N CD Z S O O U7 V O O) S m 3 Z Cl) w = cD r m � (D CD c O < :3. c CD O. a N 0 0 d N co O 0 -i g B R m N N CD O y CD 6r1 a z CD2 CD S `OG d N , Q (CL DD y a ? 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O cmi, � 2 ,- o m m m to 0< CD 1 a p C m m m d CD _� n O N c(D c c =r r O D `° 0 y d ?r 2 w �. $ c v, o CD -� fD Q CD (D o = n m O m y a n T CD Q' _ N v <D Z N y O (D N O CL to N 69 W D z O A O m S 69 A IV w W _ O n A < � v OD OD A N C CD O O Cco T -4 8 O -1cin 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 April 30, 2017 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Staff Time/April 2017 1 Civic Square Carmel,IN 46032- Invoice# 756622 Service Date Description Quanti Charae Receipt Adiust Balance 04/03/2017 N.P.Staff Time 4.00 464.24 464.24 Jennifer Hoskins 04/03/2017 M.A.Staff Time 10.00 288.40 288.40 Kimberly Pride 04/03/2017 R.N.Staff Time 8.50 542.81 542.81 Mareesa Martin 04/03/2017 Health Coach Staff Time 3.00 197.76 197.76 Marissa Grant 04/03/2017 MD Staff Time 5.00 901.25 901.25 Dr.Fagan 04/04/2017 M.A.Staff Time 7.00 201.88 201.88 Kimberly Pride 04/04/2017 R.N.Staff Time 7.00 447.02 447.02 Mareesa Martin 04/04/2017 MD Staff Time 6.00 1,081.50 1081.50 Dr.Fagan 04/05/2017 M.A.Staff Time 9.75 281.19 281.19 Kimberly Pride 04/05/2017 R.N.Staff Time 8.25 526.85 526.85 Mareesa Martin 04/05/2017 N.P.Staff Time 7.00 812.42 812.42 Michael Day 04/06/2017 M.A.Staff Time 6.25 180.25 180.25 Kimberly Pride 04/06/2017 R.N.Staff Time 5.25 335.27 335.27 Mareesa Martin 04/06/2017 Health Coach Staff Time 4.00 263.68 263.68 Marissa Grant 04/06/2017 MD Staff Time 4.00 721.00 721.00 Dr.Fagan 04/07/2017 M.A.Staff Time 6.50 187.46 187.46 Kimberly Pride Submitted To MAY 0 2 2017 Clerk Treasurer Invoice# 756622(continued)page 2 Service Date Description Quantity Charge Receipt Aust Balance 04/07/2017 R.N.Staff Time 5.50 351.23 351.23 Mareesa Martin 04/07/2017 Health Coach Staff Time 5.00 329.60 329.60 Marissa Grant 04/07/2017 MD Staff Time 5.00 901.25 901.25 Dr.Fagan 04/10/2017 M.A.Staff Time 9.50 273.98 273.98 Kimberly Pride 04/10/2017 R.N.Staff Time 9.75 622.64 622.64 Mareesa Martin 04/10/2017 Health Coach Staff Time 3.00 197.76 197.76 Marissa Grant 04/10/2017 N.P.Staff Time 4.75 551.29 551.29 Tina Nitsos 04/10/2017 MD Staff Time 5.00 901.25 901.25 Dr.Fagan 04/11/2017 M.A.Staff Time 7.00 201.88 201.88 Kimberly Pride 04/11/2017 R.N.Staff Time 7.25 462.99 462.99 Mareesa Martin 04/11/2017 MD Staff Time 6.00 1,081.50 1081.50 Dr.Fagan 04/12/2017 M.A.Staff Time 9.50 273.98 273.98 Kimberly Pride 04/12/2017 R.N.Staff Time 9.25 590.71 590.71 Mareesa Martin 04/12/2017 N.P.Staff Time 9.25 1,073.56 1073.56 Tina Nitsos 04/13/2017 M.A.Staff Time 5.00 144.20 144.20 Kimberly Pride 04/13/2017 R.N.Staff Time 5.00 319.30 319.30 Mareesa Martin 04/13/2017 MD Staff Time 4.00 721.00 721.00 Dr.Fagan 04/14/2017 M.A.Staff Time 7.25 209.09 209.09 Kimberly Pride 04/14/2017 R.N.Staff Time 7.00 447.02 447.02 Mareesa Martin 04/14/2017 Health Coach Staff Time 5.00 329.60 329.60 Marissa Grant 04/14/2017 MD Staff Time 5.00 901.25 901.25 Dr.Fagan 04/17/2017 M.A.Staff Time 9.75 281.19 281.19 Kimberly Pride 04/17/2017 R.N.Staff Time 9.75 622.64 622.64 Mareesa Martin 04/17/2017 Health Coach Staff Time 2.50 164.80 164.80 Marissa Grant Invoice# 756622(continued)page 3 Service Date Description Quantity Charge Receipt $ Balance 04/17/2017 N.P.Staff Time 4.75 551.29 551.29 Tina Nitsos 04/17/2017 MD Staff Time 5.00 901.25 901.25 Dr.Fagan 04/18/2017 M.A.Staff Time 7.00 201.88 201.88 Kimberly Pride 04/18/2017 MD Staff Time 6.00 1,081.50 1081.50 Dr.Fagan 04/19/2017 M.A.Staff Time 9.50 273.98 273.98 Kimberly Pride 04/19/2017 N.P.Staff Time 9.75 1,131.59 1131.59 Tina Nitsos 04/20/2017 M.A.Staff Time 6.25 180.25 180.25 Kimberly Pride 04/20/2017 R.N.Staff Time 5.25 335.27 335.27 Mareesa Martin 04/20/2017 Health Coach Staff Time 5.75 379.04 379.04 Marissa Grant 04/20/2017 MD Staff Time 4.00 721.00 721.00 Dr.Fagan 04/21/2017 M.A.Staff Time 6.50 187.46 187.46 Kimberly Pride 04/21/2017 Health Coach Staff Time 3.75 247.20 247.20 Marissa Grant 04/21/2017 MD Staff Time 5.00 901.25 901.25 Dr.Fagan 04/24/2017 M.A.Staff Time 9.50 273.98 273.98 Kimberly Pride 04/24/2017 R.N.Staff Time 9.75 622.64 622.64 Mareesa Martin 04/24/2017 Health Coach Staff Time 3.00 197.76 197.76 Marissa Grant 04/24/2017 N.P.Staff Time 4.75 551.29 551.29 Tina Nitsos 04/24/2017 MD Staff Time 5.00 901.25 901.25 Dr.Fagan 04/25/2017 M.A.Staff Time 7.00 201.88 201.88 Kimberly Pride 04/25/2017 R.N.Staff Time 7.25 462.99 462.99 Mareesa Martin 04/25/2017 MD Staff Time 6.00 1,081.50 1081.50 Dr.Fagan 04/26/2017 M.A.Staff Time 9.50 273.98 273.98 Kimberly Pride 04/26/2017 R.N.Staff Time 9.25 590.71 590.71 Mareesa Martin 04/26/2017 N.P.Staff Time 9.25 1,073.56 1073.56 Tina Nitsos Invoice# 756622(continued)page 4 Service Date Description Quantity Charae Receipt AIsd;:Y Balance 04/27/2017 M.A.Staff Time 5.00 144.20 144.20 Kimberly Pride 04/27/2017 R.N.Staff Time 5.25 335.27 335.27 Mareesa Martin 04/27/2017 Health Coach Staff Time 5.50 362.56 362.56 Marissa Grant 04/27/2017 MD Staff Time 4.00 721.00 721.00 Dr.Fagan 04/28/2017 M.A.Staff Time 7.25 209.09 209.09 Kimberly Pride 04/28/2017 R.N.Staff Time 6.75 431.06 431.06 Mareesa Martin 04/28/2017 Health Coach Staff Time 4.50 296.64 296.64 Marissa Grant 04/28/2017 MD Staff Time 5.00 901.25 901.25 Dr.Fagan CITYCARO Invoice# 756622 Balance Due: 36112.26 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK w Cut and return with payment Indiana University Health Workplace Services, LLC 950 North Meridian Street -3,1 Suite 950 Indianapolis, IN 46204 317-963-1535 Tax ID# 20-0994452 Invoice April 30, 2017 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Onsite Fee's/April 2017 1 Civic Square Carmel,IN 46032- Invoice# 756621 Service Date Description Quantity Charge Receipt A&g Balance 04/01/2017 City of Carmel Sports Performance 1.00 1,800.00 1800.00 Lease 04/01/2017 City of Carmel Clinic Build Out 1.00 2,574.16 2574.16 CITYCARO Invoice# 756621 Balance Due: 4374.16 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK Submitted To MAY 0 2 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 April 30, 2017 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Misc.Onsite/April 2017 1 Civic Square Carmel,IN 46032- Invoice# 756620 Service Date Description Quanti Chase Receipt A" Balance 03/01/2017 Onsite Lab Charges 1.00 2,632.85 2632.85 March 2017 Labs 03/20/2017 AS Medical Solutions Clinic Meds 1.00 143.11 143.11 03/22/2017 AS Medical Solutions Clinic Meds 1.00 149.63 149.63 03/23/2017 AS Medical Solutions Clinic Meds 1.00 8.82 8.82 03/29/2017 AS Medical Solutions Clinic Meds 1.00 1,005.76 1005.76 03/31/2017 Video Visit 1.00 49.00 49.00 March 2017 Video Visits 04/01/2017 AS Medical Solutions Clinic Meds 1.00 2,272.52 2272.52 04/01/2017 Young at Heart Mail-Ins 1.00 362.84 362.84 04/12/2017 AS Medical Solutions Mail-In Meds 1.00 12,548.01 12548.01 04/12/2017 AS Medical Solutions Clinic Meds 1.00 306.90 306.90 04/18/2017 AS Medical Solutions Clinic Meds 1.00 869.23 869.23 CITYCARO Invoice# 756620 Balance Due: 20348.67 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK Submitted To MAY 0 2 2017 t'lerk Treasurer _ Cut and return with payment 3:1 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 April 30, 2017 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite PEPM/Apri12017 1 Civic Square Carmel,IN 46032- Invoice# 756706 Service Date Description Quantity Charae ReceipBalance 04/01/2017 Monthly Wellness PEPM 619.00 1,268.95 1268.95 CITYCARO Invoice# 756706 Balance Due: 1268.95 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK Submitted To MAY 0 2 201 Clerk Treasurer w 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 April 30, 2017 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Supply Billing/April 2017 1 Civic Square Carmel,IN 46032- Invoice# 756972 Service Date Description Quantity Charae Receipt AS11S1&S Balance 04/01/2017 Onsite Operating Supplies 1.00 447.00 447.00 April 2017 Supplies CITYCARO Invoice# 756972 Balance Due: 447.00 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK Submitted To MAY 0 2 2017 Clerk Treasurer Indiana University Health Workplace Services, LLC 3J) 950 North Meridian Street Suite 950 (City of Carmel) Indianapolis, IN 46204 317-963-1535 Tax I D# 20-0994452 Invoice April 30, 2017 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Wellness UDS/April 2017 1 Civic Square Carmel,IN 46032- Invoice# 756986 Service Date Description Quantity Charge Receipt B" Balance 03/21/2017 Quick Read UDS/6panel includes 15.00 03/21/2017 Quick Read UDS/6panel includes 1.00 15.00 15.00 kit s.. Submitted To MAY 0 2 2017 Clerk Treasurer Invoice# 756986(continued)page 2 Service Date Description Quantity Charge Receipt Aust Balance 165.00 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK r..*—i-mm with navment n n N) « @ 70 O / f : O \ o w# 2 6 m0 / °} n k M \ # ?Q _ > I m X $ -4 \ CD Z / \ / / d A O / $ 7 k ^ 4 q / k ƒ 7 9) 0 m S -n > / » C)_ § q m� @ # � _k m_ g $ ° M CL z a z 2 \ # K C X . } 8 z \ ; 9 - z > % $ \ 2 g Z e k ` \ / / \ 2 E F o m n H 0 j q ƒ k n § , U 7 E m # ¥ E E2 { C E;§ / E _ C - k co J % 3 § \ \ a o ; m » o E g E , Z k K i3 - \ / w; EFg 0 « § _ \ E ; k7 \ 7 w m ° /7 cn \ § ) \ ( 0k } > '1 )/ (-) � \ Zk � k \ g2 § M ƒ C ; g # # # $ a CA Z > \ ( 0< cr 9 —< " f ƒ Q > �± E \ ; -< )o & 7 0 D �7 nm 2 D � § k \ \ \ M n \ \ \ U m c E 7 f z E g A ( ƒ C:f / e v § _ CD / / / ° CD 0 / \ M \ c R m ;u ] k & \ \ F \ f § CL _ & g ƒ M Ol } § w l 4' 5 Indiana University Health Workplace Services, LLC l� 950 North Meridian Street �ZSS Suite 950 (City of Carmel) Indianapolis, IN 46204 317-963-1535 Tax ID# 20-0994452 Invoice April 30, 2017 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite EAP Services/April 2017 1 Civic Square Carmel,IN 46032- Invoice# 756705 Service Date Description Quantity Charge Receipt Aeml Balance 04/01/2017 EAP Services 630.00 756.00 756.00 CITYCARO Invoice# 756705 Balance Due: 756.00 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK Submitted To MAY #2 2017 Clerk Treasurer Cut and return with payment 0 n 0 / m « \ } > � > / 7 A n S ^ m \ q e -4 z z C o ƒ 7 \ 2 0) O i al 00 X X 4 m § O ^ > co / \ g ƒ 6 m � -n / Cl) 3 X » \ j C 0 $ ° ® 2 r- 3 ? 0 2 ° > O § \ { k = o w | $ J % g L - 2 > £ 0 p I ? 0 k � 0 0 0 K / § 2 ? ; o ƒ + - $ - m / « E E ) 0 2 § $ ® E _ CL - § ƒ $ 3 8 ƒ m « . a ƒ 7 \ % a § ƒ I [ Eca 4 R =r§ a / 0) a E § k ƒ § e R g C i S q o i \ ƒ § /� � E ; 2 \ n 0 \ 0 7 \ \ ® C / A § o 0 EL CD � k ƒ } R E ° % 2 Q mn m / } § a< / / } T § /f a 0 > . » E \ ¢ �o 0 a @ �7 $ _ e m R ® / CD � 2 / \ m n ? / 0 0 E c � r O � ¥ ; $ Z \ ] i ( CDC % CD cn / E § } } � n CL k / f M / CD ] \ \ / OL > \ { § _ K k PD 0 . \ 8 § � ® k 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 April 30, 2017 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Occupational DS/April 1 Civic Square Carmel,IN 46032- Invoice# 756576 Service Date Description Quantity Charge Receipt Adiust Balance 04/20/2017 Quick Read UDS/6panel 15.00 kit Submitted To MAY #12017 Clerk Treasurer Invoice# 756576(continued)page 2 Service Date Description 15.00 kit Invoice# 756576(continued)page 3 Service Date Description 300.00 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK _-a