313818 7/18/2017 ��� �'"`�. CITY OF CARMEL, INDIANA VENDOR: 367222
IU HEALTH WORKPLACE SERVICES LLCC HECK AMOUNT: S"""72,831.03*
«; t.
e ONE CIVIC SQUARE 2046 RELIABLE PKWY CHECK NUMBER: 313818
=4 CARMEL, INDIANA 46032 CHICAGO IL 60686-0020 CHECK DATE: 07/18/17
9
DESCRIPTION
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT
1201 TESTING FEES
4358800 757723 150.00 J OTHER EXPENSES
301 5023990 757842 4,374.161,240.25- OTHER EXPENSES
301 5023990 757843 OTHER EXPENSES
301 5023990 757853 41,618.31-'
757856 165.00 OTHER EXPENSES
301 5023990 24,118.79- OTHER EXPENSES
301 5023990 758044 118.10 GENERAL INSURANCE
1205 4347500 758115 239.42 OTHER EXPENSES
301 5023990 758203
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Indiana University Health Workplace Services,LLC
950 North Meridian Street
/o7 Suite 950 (City of Carmel)
r� Indianapolis, IN 46204
317-963-1535
Tax ID# 20-0994452
Invoice
June 30, 2017
Bill to: Barbara Lamb For: City of Carmel-Onsite
City of Carmel-Onsite EAP Services/June 2017
1 Civic Square
Carmel,IN 46032-
Invoice# 758115
Service Date Description Quantity Charge Receipt A" Balance
06/01/2017 EAP Services 638.00 925.10 925.10
CITYCARO Invoice# 758115 Balance Due: 925.10
MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE
INVOICE#ON CHECK
Submitted To
JUL 11 2017
Clerk Treasurer
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Invoice# 757853 (continued)page 4
Service Date Description Quantity Charae Receipt A" Balance
06/23/2017 MD Staff Time 5.00 901.25 901.25
Dr.Fagan
06/23/2017 M.A.Staff Time 6.75 194.67 194.67
Kimberly Pride
06/26/2017 Health Coach Staff Time 3.00 197.76 197.76
Marissa Grant
06/26/2017 MD Staff Time 5.00 901.25 901.25
Dr.Fagan
06/26/2017 N.P.Staff Time 4.75 551.29 551.29
Tina Nitsos
06/26/2017 R.N.Staff Time 9.00 574.74 574.74
Betty Hartley
06/26/2017 M.A.Staff Time 10.00 288.40 288.40
Kimberly Pride
06/27/2017 R.N.Staff Time 7.00 447.02 447.02
Bonita Richardson
06/27/2017 MD Staff Time 6.00 1,081.50 1081.50
Dr.Fagan
06/27/2017 M.A.Staff Time 8.25 237.93 237.93
Kimberly Pride
06/28/2017 N.P.Staff Time 9.25 1,073.56 1073.56
Tina Nitsos
06/28/2017 R.N.Staff Time 9.00 574.74 574.74
Betty Hartley
06/28/2017 M.A.Staff Time 10.75 310.03 310.03
Kimberly Pride
06/29/2017 R.N.Staff Time 5.00 319.30 319.30
Mischa Cook
06/29/2017 Health Coach Staff Time 4.50 296.64 296.64
Marissa Grant
06/29/2017 MD Staff Time 4.00 721.00 721.00
Dr.Fagan
06/29/2017 M.A.Staff Time 7.75 223.51 223.51
Kimberly Pride
06/30/2017 R.N.Staff Time 5.00 319.30 319.30
Bonita Richardson
06/30/2017 Health Coach Staff Time 4.50 296.64 296.64
Marissa Grant
06/30/2017 MD Staff Time 5.00 901.25 901.25
Dr.Fagan
06/30/2017 M.A.Staff Time 7.50 216.30 216.30
Kimberly Pride
CITYCARO Invoice# 757853 Balance Due: 41618.31
MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE
INVOICE#ON CHECK
w _ Cut and return with navment
Indiana University Health Workplace Services, LLC 3�
950 North Meridian Street
Suite 950 (City of Carmel)
Indianapolis, IN 46204
317-963-1535 =
Tax I D# 20-0994452
Invoice
June 30, 2017
Bill to: Barbara Lamb For: City of Carmel-Onsite
City of Carmel-Onsite Wellness UDS/June 2017
1 Civic Square
Carmel,IN 46032-
Invoice# 757846
Service Date Description
15.00
kit
Subm::ted To
JUL 112017
Clerk Treasurer
Invoice# 757846(continued)page 2
Service Date Description Quantity Charoe Receipt Aetal Balance
165.00
MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE
INVOICE#ON CHECK
('nt and rnt...n.with nnvment
Indiana University Health Workplace Services, LLC
950 North Meridian Street
Suite 950 (City of Carmel)
Indianapolis, IN 46204 of
317-963-1535
Tax ID# 20-0994452
Invoice
June 30, 2017
Bill to: Barbara Lamb For: City of Carmel-Onsite
City of Carmel-Onsite PEPM/June 2017
1 Civic Square
Carmel,IN 46032-
Invoice# 757843
Service Date Description Quantity Charae Receip AO-151 Balance
06/01/2017 Monthly Wellness PEPM 605.00 1,240.25 1240.25
CITYCARO Invoice# 757843 Balance Due: 1240.25
MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE
INVOICE#ON CHECK
Submitted To
JUL 11 2017
Clerk Treasurer
--------------------------------------------------
Indiana University Health Workplace Services,LLC
950 North Meridian Street
Suite 950
Indianapolis, IN 46204
317-963-1535
Tax ID# 20-0994452
Invoice
June 30, 2017
Bill to: Barbara Lamb For: City of Carmel-Onsite
City of Carmel-Onsite Onsite Fee's/June 2017
1 Civic Square
Carmel,IN 46032-
Invoice# 757842
Service Date Description Quantity Charge Receipt AU-9 Balance
06/01/2017 City of Carmel Sports Performance 1.00 1,800.00 1800.00
Lease
06/01/2017 City of Carmel Clinic Build Out 1.00 2,574.16 2574.16
CITYCARO Invoice# 757842 Balance Due: 4374.16
MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE
INVOICE#ON CHECK
FSOmmitted To
112017
Clerk Treasurer
-------------------------------------------------------
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
June 30, 2017
Bill to: Barbara Lamb For: City of Carmel-Onsite
City of Carmel-Onsite Supply Billing/June 2017
1 Civic Square
Carmel,IN 46032-
Invoice# 758203
Service Date Description 4uanti2X Charge Receipt Ad" Balance
06/01/2017 Onsite Operating Supplies 1.00 239.42 239.42
June 2017 Supplies
CITYCARO Invoice# 758203 Balance Due: 239.42
MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE
INVOICE#ON CHECK
Submitted To
JUL 112017
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
June 30, 2017
Bill to: Barbara Lamb For: City of Carmel-Onsite
City of Carmel-Onsite Misc.Onsite/June 2017
1 Civic Square
Carmel,IN 46032-
Invoice# 758044
Service Date Description Quanti Charae geceiRI Ai t lBalance
05/01/2017 Onsite Lab Charges 1.00 3,800.38 3800.38
May 2017 Labs
05/18/2017 AS Medical Solutions Clinic Meds 1.00 94.54 94.54
05/22/2017 AS Medical Solutions Clinic Meds 1.00 770.28 770.28
05/25/2017 AS Medical Solutions Mail-In Meds 1.00 3,088.86 3088.86
05/26/2017 AS Medical Solutions Mail-In Meds 1.00 8,762.16 8762.16
06/01/2017 AS Medical Solutions Clinic Meds 1.00 403.45 403.45
06/05/2017 AS Medical Solutions Clinic Meds 1.00 467.11 467.11
06/07/2017 AS Medical Solutions Mail-In Meds 1.00 4,279.03 4279.03
06/13/2017 AS Medical Solutions Mail-In Meds 1.00 994.05 994.05
06/14/2017 AS Medical Solutions Clinic Meds 1.00 1,357.24 1357.24
06/15/2017 AS Medical Solutions Clinic Meds 1.00 101.69 101.69
CITYCARO Invoice# 758044 Balance Due: 24118.79
MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE
INVOICE#ON CHECK
Submitted To
JUL 1 1 2017
Clerk Treasurer
w a 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
June 30, 2017
Bill to: Barbara Lamb For: City of Carmel-Onsite
City of Carmel-Onsite Staff Time/June 2017
1 Civic Square
Carmel,IN 46032-
Invoice# 757853
Service Date Description Quantity Charoe Receipt A&W Balance
05/29/2017 M.A.Staff Time 8.00 230.72 230.72
Kimberly Pride
06/01/2017 R.N.Staff Time 5.00 319.30 319.30
Bonita Richardson
06/01/2017 M.A.Staff Time 9.50 273.98 273.98
Kimberly Pride
06/01/2017 Health Coach Staff Time 4.00 263.68 263.68
Marissa Grant
06/01/2017 MD Staff Time 4.00 721.00 721.00
Dr.Fagan
06/02/2017 M.A.Staff Time 9.50 273.98 273.98
Kimberly Pride
06/02/2017 R.N.Staff Time 5.00 319.30 319.30
Betty Hartley
06/02/2017 MD Staff Time 5.00 901.25 901.25
Dr.Fagan
06/05/2017 R.N.Staff Time 8.50 542.81 542.81
Mischa Cook
06/05/2017 M.A.Staff Time 12.00 346.08 346.08
Kimberly Pride
06/05/2017 N.P.Staff Time 5.25 609.32 609.32
Tina Nitsos
06/05/2017 Health Coach Staff Time 3.00 197.76 197.76
Marissa Grant
06/05/2017 MD Staff Time 5.00 901.25 901.25
Dr.Fagan
06/06/2017 R.N.Staff Time 7.00 447.02 447.02
Bonita Richardson
06/06/2017 M.A.Staff Time 9.00 259.56 259.56
Kimberly Pride
06/06/2017 MD Staff Time 6.00 1,081.50 1081.50
Dr.Fagan
FJULSubm"t-ted To
11 2017
Clerk Treasurer
Invoice# 757853 (continued)page 2
Service Date Descri tp ion Quantity Charge Receipt A�iust Balance
06/07/2017 R.N.Staff Time 8.00 510.88 510.88
Bonita Richardson
06/07/2017 M.A.Staff Time 12.75 367.71 367.71
Kimberly Pride
06/07/2017 N.P.Staff Time 9.25 1,073.56 1073.56
Tina Nitsos
06/08/2017 R.N.Staff Time 5.00 319.30 319.30
Mischa Cook
06/08/2017 M.A.Staff Time 8.00 230.72 230.72
Kimberly Pride
06/08/2017 Health Coach Staff Time 4.50 296.64 296.64
Marissa Grant
06/08/2017 MD Staff Time 4.00 721.00 721.00
Dr.Fagan
06/09/2017 R.N.Staff Time 5.00 319.30 319.30
Mischa Cook
06/09/2017 M.A.Staff Time 8.25 237.93 237.93
Kimberly Pride
06/09/2017 Health Coach Staff Time 4.50 296.64 296.64
Marissa Grant
06/09/2017 MD Staff Time 5.00 901.25 901.25
Dr.Fagan
06/12/2017 R.N.Staff Time 8.50 542.81 542.81
Mischa Cook
06/12/2017 Health Coach Staff Time 3.00 197.76 197.76
Marissa Grant
06/12/2017 MD Staff Time 5.00 901.25 901.25
Dr.Fagan
06/12/2017 N.P.Staff Time 4.75 551.29 551.29
Tina Nitsos
06/12/2017 M.A.Staff Time 10.00 288.40 288.40
Kimberly Pride
06/13/2017 R.N.Staff Time 7.00 447.02 447.02
Bonita Richardson
06/13/2017 MD Staff Time 6.00 1,081.50 1081.50
Dr.Fagan
06/13/2017 M.A.Staff Time 8.25 237.93 237.93
Kimberly Pride
06/14/2017 N.P.Staff Time 9.25 1,073.56 1073.56
Tina Nitsos
06/14/2017 R.N.Staff Time 9.00 574.74 574.74
Betty Hartley
06/14/2017 M.A.Staff Time 10.75 310.03 310.03
Kimberly Pride
06/15/2017 Health Coach Staff Time 4.00 263.68 263.68
Marissa Grant
06/15/2017 R.N.Staff Time 5.00 319.30 319.30
Bonita Richardson
Invoice# 757853 (continued)page 3
Service Date Description Quantity Charae Receipt Adiust Balance
06/15/2017 MD Staff Time 4.00 721.00 721.00
Dr.Fagan
06/15/2017 N.P.Staff Time 1.00 116.06 116.06
Tina Nitsos
06/15/2017 M.A.Staff Time 7.75 223.51 223.51
Kimberly Pride
06/16/2017 Health Coach Staff Time 5.00 329.60 329.60
Marissa Grant
06/16/2017 MD Staff Time 5.00 901.25 901.25
Dr.Fagan
06/16/2017 R.N.Staff Time 5.25 335.27 335.27
Amy Hurst
06/16/2017 M.A.Staff Time 7.50 216.30 216.30
Kimberly Pride
06/19/2017 Health Coach Staff Time 2.50 164.80 164.80
Marissa Grant
06/19/2017 MD Staff Time 5.00 901.25 901.25
Dr.Fagan
06/19/2017 N.P.Staff Time 4.75 551.29 551.29
Tina Nitsos
06/19/2017 R.N.Staff Time 9.00 574.74 574.74
Betty Hartley
06/19/2017 M.A.Staff Time 9.75 281.19 281.19
Kimberly Pride
06/20/2017 R.N.Staff Time 7.00 447.02 447.02
Bonita Richardson
06/20/2017 MD Staff Time 6.00 1,081.50 1081.50
Dr.Fagan
06/20/2017 M.A.Staff Time 7.50 216.30 216.30
Kimberly Pride
06/21/2017 N.P.Staff Time 9.25 1,073.56 1073.56
Tina Nitsos
06/21/2017 R.N.Staff Time 9.00 574.74 574.74
Betty Hartley
06/21/2017 M.A.Staff Time 10.75 310.03 310.03
Kimberly Pride
06/22/2017 R.N.Staff Time 5.25 335.27 335.27
Mischa Cook
06/22/2017 Health Coach Staff Time 5.00 329.60 329.60
Marissa Grant
06/22/2017 MD Staff Time 4.00 721.00 721.00
Dr.Fagan
06/22/2017 M.A.Staff Time 7.50 216.30 216.30
Kimberly Pride
06/23/2017 R.N.Staff Time 5.00 319.30 319.30
Mischa Cook
06/23/2017 Health Coach Staff Time 4.50 296.64 296.64
Marissa Grant
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Indiana University Health Workplace Services,LLC
950 North Meridian Street
p Suite 950 (City of Carmel)
Indianapolis, IN 46204
317-963-1535
Tax ID# 20-0994452
Invoice
June 30, 2017
Bill to: Barbara Lamb For: City of Carmel-Onsite
City of Carmel-Onsite Occupational/UDS/June
1 Civic Square
Carmel,IN 46032-
Invoice# 757723
Service Date Description Quantity Charae Receipt Aayg Balance
06/12/2017 Quick Read UDS/6panel
15.00
06/05/2017 Quick Read UDS/6panel includes 1.00 15.00 15.00
kit
Submitted To
JUL 1 1 2017
Clerk Treasurer
Invoice# 757723 (continued)page 2
Service Date Description
150.00
MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE
INVOICE#ON CHECK
Cut and return with payment
-----------------------
- --- "'-"