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Home My WebLink About311846 05/30/17 9, ) CITY OF CARMEL, INDIANA VENDOR: 00350364 ONE CIVIC SQUARE PUBLIC SAFETY MEDICAL SERVICES CHECK AMOUNT: 5'"""1,743.24' CARMEL, INDIANA 46032 324 E NEW YORK ST SUITE 300 CHECK NUMBER: 311846 INDIANAPOLIS IN 46204 CHECK DATE: 05/30/17 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1110 4340701 100018 00-30594 768.90 OFFICER PHYSICALS 1110 4340701 100018 00-30639 974.34 OFFICER PHYSICALS / w -0 < < » 7 O b k q 0 X822 2 D m r � A # $ $ b # ? 0 3 / q q K 8 z k k O CA nA @ m # ( 2 -n q q ® Q ¢ � $ 2 c > E \ 2 m $ \ § \ C \ C k k_ 3 e X kU) § ? 2 J > -n O 40 CD w O coz = o w 6 ) i a 9 - z > _ % g W Z c § k i n / § K m 7 \ a ; -n v CD CL 2 § ¥ - � - m 2 CD ; 2 k D E 2 / CD ( CD J f + . E - K ) ! \ 8 0 m a rq- Q ga\ C \/ CL CD CL \ CL < 0) w �% ( 0 E f = a ƒ § C ® e o / » - e 0 a ƒ 7 %I , ] § & - \ mCD _ C » [ 2 i D 3 .# ) cr 0) 7 § � $ ® 0 co // CA CD 03 § ƒ C 5L ) 0 7CL 0 z 0> / $/ r 3 / n< 7 _0 ®f = D /_ƒ ( / ( ) o a E & nm o ; \ K M n / \ j E / c r % ] / � CD C % CD k E $ CD \ CD§ � 2 M \ m § \ \ / CL > \ \ § » q § \ s CD i � ® \ Public Safety Medical - INVOICE Public Safety Medical Invoice Date: 05/12/2017 324 E. New York Street Invoice# 00-30594 E Suite 300 Terms: tY Indianapolis, IN 46204 c Carmel Police Department/CARMEPD 1- (SS) Pyoung@carmel.In.Gov m (W)Tgreen@carmel.In.Gov Exclusively Serving Public Safety Professionals Since 1990. Date Employee Description Amount Balance Due 05/02/17 Dunlap, hrit h r T. HIV-4th Gen Rapid T I Venipuncture $3.53 $3.53 Lipid Panel Blood 23.82 $23.8 CBC(Comp Blood Count 20.29 $20.2 CMP C rnp Metabolic Panel 22.41 $22.41 PSA-Prostate Specific A Blood 0.99 $40.99 Frost Dwight D. HIV-4th Gen Rapid Test Blood 25.93 $25.9 Venipuncture $3.53 $3.53 Li id Panel Blood 23.82 $23.821 BC(CornD Blood Count) $20.29 2 .2 CMP(Comp Metabolic Panel) $22.41 $22.41 PSA-Prostate 'fi I Gilmore. Gen Rapid Venipuncture $3.53 $3.53 Lipid Panel Blood 23.82 $23.82 CBC(Comp Blood Count 20.29 $20.2 CMP(Comp Metabolic Panel 22.41 $22.41 Govin John K. HIV-4th Gen Rapid Test Blood 25.93 $25.9 Venipuncture $3.53 $3.53 Li id Panel Blood 23.82 $23.82 CBC(Comp Blood Count 20.29 $20.2 CMP(Comp Metabolic Panel 22.41 $22.41 Hood,Bryan L. HIV-4th Gen Rapid Test BIood) $25.93 $25.9 Venipuncture PanelLipid I CBC(Comp Blood Count $20.29 $20.2 CMP(Comp Metabolic Panel 22.41 $22.41 Martin Brian A. HIV-4th Gen Rapid Test Blood 25.93 $25.93 Venipuncture $3.53 $3.53 Lipid Panel Blood 23.82 $23.82 CBC(Comp Blood Count 20.29 $20.29 CMP(CornD Metabolic Panel 22.41 $22.41 Paris Mark J. Veni uncture $3.53 $3.53 Lipid Panel BI d 23. 2 $23.82 B (Comp BloodCount) 20.2 2 .2 I CMP(Comp Metabolic Panel) Public Safety Medical - INVOICE o Public Safety Medical Invoice Date: 05/12/2017 = 324 E. New York Street Invoice# 00-30594 E Suite 300 Terms: W Indianapolis, IN 46204 C Carmel Police Department/CARMEPD (SS) Pyoung@carmel.In.Gov 00 (W)Tgreen@carmel.In.Gov Exclusively Serving Public Safety Professionals Since 1990. Date Employee Description Amount Balance Due Total Charges->1 $768.90 Total Payments&Balance Due->1 $0.00 �$768,90 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. C..) -0 « « k m O k ms ' ? � 88 u2 2 D m r— / k 00 ° » $ z # ? \ 0 0 C/) E K 8 k k k O % C.0 Q w 2 w \ co � \ a _ D cn � E } 2 2 M ® k T. } \ § \ � \ k k M ] 6 § # # ;u CL \ q 2 ? 2 7 > O /_ co \ k (D k z | =r Ja ! 2 2 - z > z k / ma k ƒ c 3 % i g § F F n o m -n k § ( / i - E 7 - m 0 / f k Q f a) CD ( \ m ± CL a 0 / G CD ) \ §\ 00 ] - o E g B § CDk / \ ca C) 2 CL 7 - ƒ N I k/ } � k« \ + 0 c CL \ 7 c > CD 0 CD » § 2 a cr - 0) n \ \\ r D / 27 2 ) \ E CD 0 Cd0 § § m ƒ C o ; / co D 0 z CD / Kk \ �< % % 2 g e\ / 0 > }f D ( �o 03o a E \ RR � � / r / 2 / CDK M n / / o SD 0 0 U / c r _ \ / { ƒ C + J o G C E $ { } 0 n CD � / f \ CL ] \ z / > \ \ § $ § \ 2 7 \ k co ® co Public Safety Medical - INVOICE 1 Public Safety Medical Invoice Date: 05/19/2017 324 E.New York Street Invoice# 00-30639 mSuite 300 Terms: g Indianapolis, IN 46204 Carmel Police Department/CARMEPD Pat Young mPyoung@carmel.In.Gov Exclusively Serving Public Safety Professionals Since 1990. Data. Employee Description_ Amount Balance Due Respirator/Medical Review $18.74 $18.7 Health Risk Appraisal Motivation 0.00 $0.00 Comprehensive Physical Exam $114.77 $114.77 Waist/Hi Ratio $3.53 3.53 Bodv Fat Test-BIA Bio-Elec I=Anal 16.40 $16.40 Treadmill-Submax $179.11 $179.11 Muscular SUen th Endurance Test $30.45 $30.45 Flexibility Test $11.72 11.7 Urinalysis-Dipstick EKG W/Interp $23.42 Audiorn try $16.40 $1 6.4d PFT-P lmonary Function Test $38.65 Vision-Acuity Vital Si ns-HT WT BP P R 0.00 Renforth Trevor M. OnMed Pr ram 0.00 Res irator/Medical Review 18.74 Health Risk raisal Motivation 0.00 $0.001 Com rehensive Physical Exam $114.77 $114.77 Waist/Hi Ratio $3.53 $3.53 Body Fat Test-BIA Bio-Elec Imp Analy) $16.40 $16.4 Treadmill-Submax $179.11 $179.11 Muscular U th Endurance Test $30.45 $30.45 Flexibility Test $11.72 $11.7d t Inte j$30.45 2 fl3Q. et 0 ulmona Function Test 5 Vision-Acuity Vital Si ns-HT WT BP P R 0 Total Charges--> 974.34 Total Payments$Balance Due $0.00 $974.34 Public Safety Medical - INVOICE H Public Safety Medical Invoice Date: 05/19/2017 324 E. New York Street Invoice# 00-30639 E Suite 300 Terms: Indianapolis, IN 46204 c Carmel Police Department/CARMEPD H Pat Young m Pyoung@carmel.In.Gov Exclusively Serving Public Safety Professionals Since 1990. Date Employee Description Amount I Balance Due 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. 9, ) CITY OF CARMEL, INDIANA VENDOR: 00350364 ONE CIVIC SQUARE PUBLIC SAFETY MEDICAL SERVICES CHECK AMOUNT: 5'"""1,743.24' CARMEL, INDIANA 46032 324 E NEW YORK ST SUITE 300 CHECK NUMBER: 311846 INDIANAPOLIS IN 46204 CHECK DATE: 05/30/17 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1110 4340701 100018 00-30594 768.90 OFFICER PHYSICALS 1110 4340701 100018 00-30639 974.34 OFFICER PHYSICALS / w -0 < < » 7 O b k q 0 X822 2 D m r � A # $ $ b # ? 0 3 / q q K 8 z k k O CA nA @ m # ( 2 -n q q ® Q ¢ � $ 2 c > E \ 2 m $ \ § \ C \ C k k_ 3 e X kU) § ? 2 J > -n O 40 CD w O coz = o w 6 ) i a 9 - z > _ % g W Z c § k i n / § K m 7 \ a ; -n v CD CL 2 § ¥ - � - m 2 CD ; 2 k D E 2 / CD ( CD J f + . E - K ) ! \ 8 0 m a rq- Q ga\ C \/ CL CD CL \ CL < 0) w �% ( 0 E f = a ƒ § C ® e o / » - e 0 a ƒ 7 %I , ] § & - \ mCD _ C » [ 2 i D 3 .# ) cr 0) 7 § � $ ® 0 co // CA CD 03 § ƒ C 5L ) 0 7CL 0 z 0> / $/ r 3 / n< 7 _0 ®f = D /_ƒ ( / ( ) o a E & nm o ; \ K M n / \ j E / c r % ] / � CD C % CD k E $ CD \ CD§ � 2 M \ m § \ \ / CL > \ \ § » q § \ s CD i � ® \ Public Safety Medical - INVOICE Public Safety Medical Invoice Date: 05/12/2017 324 E. New York Street Invoice# 00-30594 E Suite 300 Terms: tY Indianapolis, IN 46204 c Carmel Police Department/CARMEPD 1- (SS) Pyoung@carmel.In.Gov m (W)Tgreen@carmel.In.Gov Exclusively Serving Public Safety Professionals Since 1990. Date Employee Description Amount Balance Due 05/02/17 Dunlap, hrit h r T. HIV-4th Gen Rapid T I Venipuncture $3.53 $3.53 Lipid Panel Blood 23.82 $23.8 CBC(Comp Blood Count 20.29 $20.2 CMP C rnp Metabolic Panel 22.41 $22.41 PSA-Prostate Specific A Blood 0.99 $40.99 Frost Dwight D. HIV-4th Gen Rapid Test Blood 25.93 $25.9 Venipuncture $3.53 $3.53 Li id Panel Blood 23.82 $23.821 BC(CornD Blood Count) $20.29 2 .2 CMP(Comp Metabolic Panel) $22.41 $22.41 PSA-Prostate 'fi I Gilmore. Gen Rapid Venipuncture $3.53 $3.53 Lipid Panel Blood 23.82 $23.82 CBC(Comp Blood Count 20.29 $20.2 CMP(Comp Metabolic Panel 22.41 $22.41 Govin John K. HIV-4th Gen Rapid Test Blood 25.93 $25.9 Venipuncture $3.53 $3.53 Li id Panel Blood 23.82 $23.82 CBC(Comp Blood Count 20.29 $20.2 CMP(Comp Metabolic Panel 22.41 $22.41 Hood,Bryan L. HIV-4th Gen Rapid Test BIood) $25.93 $25.9 Venipuncture PanelLipid I CBC(Comp Blood Count $20.29 $20.2 CMP(Comp Metabolic Panel 22.41 $22.41 Martin Brian A. HIV-4th Gen Rapid Test Blood 25.93 $25.93 Venipuncture $3.53 $3.53 Lipid Panel Blood 23.82 $23.82 CBC(Comp Blood Count 20.29 $20.29 CMP(CornD Metabolic Panel 22.41 $22.41 Paris Mark J. Veni uncture $3.53 $3.53 Lipid Panel BI d 23. 2 $23.82 B (Comp BloodCount) 20.2 2 .2 I CMP(Comp Metabolic Panel) Public Safety Medical - INVOICE o Public Safety Medical Invoice Date: 05/12/2017 = 324 E. New York Street Invoice# 00-30594 E Suite 300 Terms: W Indianapolis, IN 46204 C Carmel Police Department/CARMEPD (SS) Pyoung@carmel.In.Gov 00 (W)Tgreen@carmel.In.Gov Exclusively Serving Public Safety Professionals Since 1990. Date Employee Description Amount Balance Due Total Charges->1 $768.90 Total Payments&Balance Due->1 $0.00 �$768,90 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. C..) -0 « « k m O k ms ' ? � 88 u2 2 D m r— / k 00 ° » $ z # ? \ 0 0 C/) E K 8 k k k O % C.0 Q w 2 w \ co � \ a _ D cn � E } 2 2 M ® k T. } \ § \ � \ k k M ] 6 § # # ;u CL \ q 2 ? 2 7 > O /_ co \ k (D k z | =r Ja ! 2 2 - z > z k / ma k ƒ c 3 % i g § F F n o m -n k § ( / i - E 7 - m 0 / f k Q f a) CD ( \ m ± CL a 0 / G CD ) \ §\ 00 ] - o E g B § CDk / \ ca C) 2 CL 7 - ƒ N I k/ } � k« \ + 0 c CL \ 7 c > CD 0 CD » § 2 a cr - 0) n \ \\ r D / 27 2 ) \ E CD 0 Cd0 § § m ƒ C o ; / co D 0 z CD / Kk \ �< % % 2 g e\ / 0 > }f D ( �o 03o a E \ RR � � / r / 2 / CDK M n / / o SD 0 0 U / c r _ \ / { ƒ C + J o G C E $ { } 0 n CD � / f \ CL ] \ z / > \ \ § $ § \ 2 7 \ k co ® co Public Safety Medical - INVOICE 1 Public Safety Medical Invoice Date: 05/19/2017 324 E.New York Street Invoice# 00-30639 mSuite 300 Terms: g Indianapolis, IN 46204 Carmel Police Department/CARMEPD Pat Young mPyoung@carmel.In.Gov Exclusively Serving Public Safety Professionals Since 1990. Data. Employee Description_ Amount Balance Due Respirator/Medical Review $18.74 $18.7 Health Risk Appraisal Motivation 0.00 $0.00 Comprehensive Physical Exam $114.77 $114.77 Waist/Hi Ratio $3.53 3.53 Bodv Fat Test-BIA Bio-Elec I=Anal 16.40 $16.40 Treadmill-Submax $179.11 $179.11 Muscular SUen th Endurance Test $30.45 $30.45 Flexibility Test $11.72 11.7 Urinalysis-Dipstick EKG W/Interp $23.42 Audiorn try $16.40 $1 6.4d PFT-P lmonary Function Test $38.65 Vision-Acuity Vital Si ns-HT WT BP P R 0.00 Renforth Trevor M. OnMed Pr ram 0.00 Res irator/Medical Review 18.74 Health Risk raisal Motivation 0.00 $0.001 Com rehensive Physical Exam $114.77 $114.77 Waist/Hi Ratio $3.53 $3.53 Body Fat Test-BIA Bio-Elec Imp Analy) $16.40 $16.4 Treadmill-Submax $179.11 $179.11 Muscular U th Endurance Test $30.45 $30.45 Flexibility Test $11.72 $11.7d t Inte j$30.45 2 fl3Q. et 0 ulmona Function Test 5 Vision-Acuity Vital Si ns-HT WT BP P R 0 Total Charges--> 974.34 Total Payments$Balance Due $0.00 $974.34 Public Safety Medical - INVOICE H Public Safety Medical Invoice Date: 05/19/2017 324 E. New York Street Invoice# 00-30639 E Suite 300 Terms: Indianapolis, IN 46204 c Carmel Police Department/CARMEPD H Pat Young m Pyoung@carmel.In.Gov Exclusively Serving Public Safety Professionals Since 1990. Date Employee Description Amount I Balance Due 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.