312430 06/13/17 94�''''� CITY OF CARMEL, INDIANA VENDOR: 367222
ti ONE CIVIC SQUARE IU HEALTH WORKPLACE SERVICES LLCCHECK AMOUNT: S•'""54,346.20'
=q; CARMEL, INDIANA 46032 2046 RELIABLE PKWY CHECK NUMBER: 312430
,MiroN c6' CHICAGO IL 60686-0020 CHECK DATE: 06/13/17
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1201 4358800 757102 450.00 TESTING FEES
301 5023990 757105 40,347.81 OTHER EXPENSES
301 5023990 757106 1,260.75 OTHER EXPENSES
301 5023990 757107 4,374.16 OTHER EXPENSES
301 5023990 757122 4,868.64 OTHER EXPENSES
1205 4347500 757296 758.40 GENERAL INSURANCE
301 5023990 757321 165.00 OTHER EXPENSES
301 5023990 757599 2,121.44 OTHER EXPENSES
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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
May 31, 2017
Bill to: Barbara Lamb For: City of Carmel-Onsite
City of Carmel-Onsite Staff Time/May 2017
1 Civic Square
Carmel,IN 46032-
Invoice# 757105
Service Date Description Quanti Charae Receipt A," Balance
05/01/2017 R.N.Staff Time 9.00 574.74 574.74
Mareesa Martin
05/01/2017 N.P.Staff Time 4.75 551.29 551.29
Tina Nitsos
05/01/2017 M.A.Staff Time 10.25 295.61 295.61
Kimberly Pride
05/01/2017 Health Coach Staff Time 3.00 197.76 197.76
Marissa Grant
05/01/2017 MD Staff Time 5.00 901.25 901.25
Dr.Fagan
05/02/2017 R.N.Staff Time 7.00 447.02 447.02
Mareesa Martin
05/02/2017 M.A.Staff Time 7.00 201.88 201.88
Kimberly Pride
05/02/2017 MD Staff Time 6.00 1,081.50 1081.50
Dr.Fagan
05/03/2017 R.N.Staff Time 9.75 622.64 622.64
Mareesa Martin
05/03/2017 N.P.Staff Time 9.25 1,073.56 1073.56
Tina Nitsos
05/03/2017 M.A.Staff Time 9.50 273.98 273.98
Kimberly Pride
05/04/2017 R.N.Staff Time 5.50 351.23 351.23
Mareesa Martin
05/04/2017 M.A.Staff Time 5.00 144.20 144.20
Betty Hartley
05/04/2017 Health Coach Staff Time 8.75 576.80 576.80
Marissa Grant
05/04/2017 MD Staff Time 4.00 721.00 721.00
Dr.Fagan
05/05/2017 R.N.Staff Time 7.25 462.99 462.99
Mareesa Martin
Submitted To
JUN 0 6 2017
Clerk Treasurer
Invoice# 757105(continued)page 2
Service Date Description Quantity Charge Receipt Aiust Balance
05/05/2017 M.A.Staff Time 5.50 158.62 158.62
Amber Helton
05/05/2017 Health Coach Staff Time 5.50 362.56 362.56
Marissa Grant
05/05/2017 MD Staff Time 5.00 901.25 901.25
Dr.Fagan
05/08/2017 MD Staff Time 5.00 901.25 901.25
Dr.Fagan
05/08/2017 R.N.Staff Time 9.75 622.64 622.64
Mareesa Martin
05/08/2017 N.P.Staff Time 4.75 551.29 551.29
Tina Nitsos
05/08/2017 M.A.Staff Time 9.00 259.56 259.56
Betty Hartley
05/09/2017 MD Staff Time 6.00 1,081.50 1081.50
Dr.Fagan
05/09/2017 R.N.Staff Time 7.00 447.02 447.02
Mareesa Martin
05/09/2017 M.A.Staff Time 6.50 187.46 187.46
Kimberly Pride
05/10/2017 R.N.Staff Time 9.75 622.64 622.64
Mareesa Martin
05/10/2017 N.P.Staff Time 8.75 1,015.53 1015.53
Tina Nitsos
05/10/2017 M.A.Staff Time 9.50 273.98 273.98
Kimberly Pride
05/11/2017 MD Staff Time 4.00 721.00 721.00
Dr.Fagan
05/11/2017 R.N.Staff Time 5.00 319.30 319.30
Mareesa Martin
05/11/2017 M.A.Staff Time 4.75 136.99 136.99
Kimberly Pride
05/11/2017 Health Coach Staff Time 4.00 263.68 263.68
Marissa Grant
05/12/2017 MD Staff Time 5.00 901.25 901.25
Dr.Fagan
05/12/2017 R.N.Staff Time 6.25 399.13 399.13
Mareesa Martin
05/12/2017 M.A.Staff Time 6.50 187.46 187.46
Kimberly Pride
05/12/2017 Health Coach Staff Time 4.00 263.68 263.68
Marissa Grant
05/15/2017 M.A.Staff Time 11.25 324.45 324.45
Kimberly Pride
05/15/2017 Health Coach Staff Time 3.00 197.76 197.76
Marissa Grant
05/15/2017 R.N.Staff Time 10.00 638.60 638.60
Mareesa Martin
Invoice# 757105(continued)page 3
Service Date Description Quantity Charge Receipt Adiust Balance
05/15/2017 N.P.Staff Time 4.75 551.29 551.29
Tina Nitsos
05/15/2017 MD Staff Time 5.00 901.25 901.25
Dr.Sunderman
05/16/2017 M.A.Staff Time 8.25 237.93 237.93
Kimberly Pride
05/16/2017 R.N.Staff Time 9.00 574.74 574.74
Mareesa Martin
05/16/2017 N.P.Staff Time 6.00 696.36 696.36
Cheryl Graham
05/17/2017 M.A.Staff Time 11.00 317.24 317.24
Kimberly Pride
05/17/2017 R.N.Staff Time 9.25 590.71 590.71
Mareesa Martin
05/17/2017 N.P.Staff Time 9.25 1,073.56 1073.56
Tina Nitsos
05/18/2017 M.A.Staff Time 7.25 209.09 209.09
Kimberly Pride
05/18/2017 Health Coach Staff Time 4.50 296.64 296.64
Marissa Grant
05/18/2017 R.N.Staff Time 5.00 319.30 319.30
Mareesa Martin
05/18/2017 N.P.Staff Time 4.50 522.27 522.27
Tina Nitsos
05/19/2017 M.A.Staff Time 9.50 273.98 273.98
Kimberly Pride
05/19/2017 Health Coach Staff Time 4.50 296.64 296.64
Marissa Grant
05/19/2017 R.N.Staff Time 6.25 399.13 399.13
Mareesa Martin
05/19/2017 N.P.Staff Time 5.75 667.35 667.35
Tina Nitsos
05/22/2017 R.N.Staff Time 9.00 574.74 574.74
Sandy Miller
05/22/2017 M.A.Staff Time 9.00 259.56 259.56
Kimberly Pride
05/22/2017 Health Coach Staff Time 3.00 197.76 197.76
Marissa Grant
05/22/2017 N.P.Staff Time 4.75 551.29 551.29
Tina Nitsos
05/22/2017 MD Staff Time 5.00 901.25 901.25
Dr.Fagan
05/23/2017 R.N.Staff Time 6.00 383.16 383.16
Racquel Terry
05/23/2017 M.A.Staff Time 9.00 259.56 259.56
Kimberly Pride
05/23/2017 MD Staff Time 6.00 1,081.50 1081.50
Dr.Fagan
Invoice# 757105 (continued)page 4
Service Date Descdptio Quanti Charge Receipt AMig Balance
05/24/2017 R.N.Staff Time 8.50 542.81 542.81
Sandy Miller
05/24/2017 M.A.Staff Time 11.75 338.87 338.87
Kimberly Pride
05/24/2017 N.P.Staff Time 9.25 1,073.56 1073.56
Tina Nitsos
05/25/2017 R.N.Staff Time 4.00 255.44 255.44
Sandy Miller
05/25/2017 M.A.Staff Time 7.50 216.30 216.30
Kimberly Pride
05/25/2017 Health Coach Staff Time 4.50 296.64 296.64
Marissa Grant
05/25/2017 MD Staff Time 4.00 721.00 721.00
Dr.Fagan
05/26/2017 M.A.Staff Time 7.00 201.88 201.88
Kimberly Pride
05/26/2017 Health Coach Staff Time 4.50 296.64 296.64
Marissa Grant
05/26/2017 M.A.Staff Time 4.75 136.99 136.99
Amber Helton
05/26/2017 MD Staff Time 5.00 901.25 901.25
Dr.Fagan
05/30/2017 R.N.Staff Time 6.00 383.16 383.16
Racquel Terry
05/30/2017 M.A.Staff Time 7.00 201.88 201.88
Kimberly Pride
05/30/2017 MD Staff Time 6.00 1,081.50 1081.50
Dr.Fagan
05/31/2017 M.A.Staff Time 9.50 273.98 273.98
Kimberly Pride
05/31/2017 N.P.Staff Time 9.25 1,073.56 1073.56
Tina Nitsos
CITYCARO Invoice# 757105 Balance Due: 40347.81
MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE
INVOICE#ON CHECK
Cut and return with Davment
Indiana University Health Workplace Services,LLC
30� 950 North Meridian Street
Suite 950 (City of Carmel)
Indianapolis, IN 46204
317-963-1535
Tax ID# 20-0994452
Invoice
May 31, 2017
Bill to: Barbara Lamb For: City of Carmel-Onsite
City of Carmel-Onsite Misc.Onsite/May 2017
1 Civic Square
Carmel,IN 46032-
Invoice# 757122
Service Date Description Quantity Charge Receipt Adiust Balance
04/01/2017 Onsite Lab Charges 1.00 2,365.72 2365.72
April 2017 Labs
04/20/2017 AS Medical Solutions Clinic Meds 1.00 696.97 696.97
04/24/2017 AS Medical Solutions Clinic Meds 1.00 19.73 19.73
05/04/2017 AS Medical Solutions Clinic Meds 1.00 751.96 751.96
05/08/2017 AS Medical Solutions Clinic Meds 1.00 1,034.26 1034.26
CITYCARO Invoice# 757122 Balance Due: 4868.64
MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE
INVOICE#ON CHECK
Submitted To
JUN 0 6 2017
Clerk Treasurer
fbw.ad, Cut and return with payment
Indiana University Health Workplace Services,LLC
b� 950 North Meridian Street
Suite 950
Indianapolis, IN 46204
317-963-1535
Tax ID# 20-0994452
Invoice
May 31, 2017
Bill to: Barbara Lamb For: City of Carmel-Onsite
City of Carmel-Onsite Onsite Fee's/May 2017
1 Civic Square
Carmel,IN 46032-
Invoice# 757107
Service Date Description Quantity Sparge Becelp Adiust Balance
05/01/2017 City of Carmel Sports Performance 1.00 1,800.00 1800.00
Lease
05/01/2017 City of Carmel Clinic Build Out 1.00 2,574.16 2574.16
CITYCARO Invoice# 757107 Balance Due: 4374.16
MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE
INVOICE#ON CHECK
Submitted To
JUN 0 6 2017
Clerk Treasurer
w Cut and return with payment
---------------------------------------------------------------------------------
Indiana University Health Workplace Services,LLC
�U 1 950 North Meridian Street
Suite 950 (City of Carmel)
Indianapolis, IN 46204
317-963-1535
Tax ID# 20-0994452
Invoice
May 31, 2017
Bill to: Barbara Lamb For: City of Carmel-Onsite
City of Carmel-Onsite PEPM/May 2017
1 Civic Square
Carmel,IN 46032-
Invoice# 757106
Service Date Description Quantity Charae Receipt Asliu;zt Balance
05/01/2017 Monthly Wellness PEPM 615.00 1,260.75 1260.75
CITYCARO Invoice# 757106 Balance Due: 1260.75
MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE
INVOICE#ON CHECK
submitted T°
SUN 0 6 N17
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
May 31, 2017
Bill to: Barbara Lamb For: City of Carmel-Onsite
City of Carmel-Onsite Supply Billing/May 2017
1 Civic Square
Carmel,IN 46032-
Invoice# 757599
Service Date Description Quantity Charoe Receipt Adiust Balance
05/01/2017 Onsite Operating Supplies 1.00 2,121.44 2121.44
May 2017 Supplies
CITYCARO Invoice# 757599 Balance Due: 2121.44
MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE
INVOICE#ON CHECK
Submitted To
JUN 0 6 2017
Clerk Treasurer
Cut and return with payment
---------------------------------------------------------------------------------------
Indiana University Health Workplace Services,LLC
950 North Meridian Street
U� Suite 950 (City of Carmel)
Indianapolis, IN 46204
317-963-1535
Tax ID# 20-0994452
Invoice
May 31, 2017
Bill to: Barbara Lamb For: City of Carmel-Onsite
City of Carmel-Onsite Wellness DS/May 2017
1 Civic Square
Carmel,IN 46032-
Invoice# 757321
Service Date Description Quantity Charae Receipt Adiust Balance
05/17/2017 Quick Read UDS/6panel includes
15.00
05/23/2017 Quick Read UDS/6panel includes 1.00 15.00 15.00
kit
Submitted To
JUN 0 6 2017
Clerk Treasurer
Invoice# 757321 (continued)page 2
Service Date Description Quantity Charae Receipt Adj.U;i1 Balance
165.00
MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE
INVOICE#ON CHECK
Cut and retum with payment
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/ Indiana University Health Workplace Services,LLC
•1 S 950 North Meridian Street
( � Suite 950 (City of Carmel)
1 Indianapolis, IN 46204
317-963-1535
Tax ID# 20-0994452
Invoice
May 31, 2017
Bill to: Barbara Lamb For: City of Carmel-Onsite
City of Carmel-Onsite EAP Services/May 2017
1 Civic Square
Carmel,IN 46032-
Invoice# 757296
Service Date Description Quantity Charge Receipt A" Balance
05/01/2017 EAP Services 632.00 758.40 758.40
CITYCARO Invoice# 757296 Balance Due: 758.40
MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE
INVOICE#ON CHECK
Submitted To
JUN 0 6 2017
Clerk Treasurer
_j
dam- Cut and return with payment
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�I Indiana University Health Workplace Services,LLC
950 North Meridian Street
` Suite 950 (City of Carmel)
Indianapolis, IN 46204
1 317-963-1535
Tax ID# 20-0994452
Invoice
May 31, 2017
Bill to: Barbara Lamb For: City of Carmel-Onsite
City of Carmel-Onsite Occupational DS/May 2017
1 Civic Square
Carmel,IN 46032-
Invoice# 757102
Service Date Description Quantity Charge Receipt Adiust Balance
05/01/2017 Quick Read UDS/6panel includes
15.00
kit
Invoice# 757102(continued)page 2
Service Date Description Quantity Charge Receipt AU-9 Balance
15.00
05/15/2017 Quick Read UDS/6panel includes 1.00 15.00 15.00
kit
Invoice# 757102(continued)page 3
Service Date Description
15.00
Invoice# 757102(continued)page 4
Service Date Description Quantity Charge Receipt A" Balance
05/15/2017 Quick Read UDS/6panel includes 1.00 15.00 15.00
kit
15.00
CITYCARO Invoice# 757102 Balance Due: 450.00
MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE
INVOICE#ON CHECK
w Cut and return with payment