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Home My WebLink About314911 08/15/17 9`�u ��'"'� CITY OF CARMEL, INDIANA VENDOR: 367222 ONE CIVIC SQUARE IU HEALTH WORKPLACE SERVICES LLCCHECK AMOUNT: $....68,094.31 ,' � CARMEL, INDIANA 46032 2046 RELIABLE PKWY CHECK NUMBER: 314911 +*�TtiN.i°. CHICAGO IL 60686-0020 CHECK DATE: 08/15/17 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 301 5023990 758278 105.00 OTHER EXPENSES 301 5023990 758280 4,374.16 OTHER EXPENSES 301 5023990 758281 36,416.10 OTHER EXPENSES 301 5023990 758282 1,244.35 OTHER EXPENSES 301 5023990 758283 23,186.00 OTHER EXPENSES 1201 4358800 758299 67.00 TESTING FEES 1205 4347500 758582 926.55 GENERAL INSURANCE 301 5023990 758723 1,775.15 OTHER EXPENSES no n No C m < o _0O 2 _ :3O yO p O O -i it Z D m 0 1, cr n 0 � 2 O o W gC Z z rn m O N `m 00D OODD 000 0 00 00D OD O W W N O 0 OND -4 00 000 OND N m O O O r pj NOD O W W (D CD T 4 N n a 9: _0 o � m 0 E v -0 -4m o 0 0 0 0 0 n -n -1 O °' X D n W N W N W N W N W N W N 0 0 0 0 0 0 Q D Z a r —i o Z C7 Z o v, fA O < 1 owi A j D - 14 KO A Ln m A 0)CV71 0CDL, ZC S CWJI O O p O N fD3 S Z r S O C r �D• 0 N N O Q < CL 0. 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1775.15 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK Subm'Zf-ted T® AUG 0 8 2017 Clerk Treasurer �--Cut and return with payment Please remit 1,775.15 and Make Check Payable to: VISA INVOICE# 758723 IU Health Workplace Services,LLC MASTERCARD 2046 Reliable Pkwy Chicago,IL 60686-0020 ACCOUNT NO Csv ExP CODE DATE Phone: 317-963-1535 SIGNATURE AMOUNT PAID Indiana University Health Workplace Services,LLC �J 950 North Meridian Street Suite 950 (City of Carmel) Indianapolis, IN 46204 317-963-1535 Tax ID# 20-0994452 Invoice July 31, 2017 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Misc.Onsite/July 2017 1 Civic Square Cannel,IN 46032- Invoice# 758283 Service Date Description Quanti Charae Receipt A�iust Balance 06/01/2017 Onsite Lab Charges 1.00 2,806.24 2806.24 June 2017 Labs 06/09/2017 AS Medical Solutions Clinic Meds 1.00 69.77 69.77 06/21/2017 AS Medical Solutions Clinic Meds 1.00 162.53 162.53 06/28/2017 AS Medical Solutions Clinic Meds 1.00 349.72 349.72 06/29/2017 AS Medical Solutions Clinic Meds 1.00 51.71 51.71 06/30/2017 Video Visit 1.00 49.00 49.00 07/05/2017 AS Medical Solutions Clinic Meds 1.00 578.48 578.48 07/07/2017 AS Medical Solutions Clinic Meds 1.00 2.50 2.50 07/12/2017 AS Medical Solutions Mail-In Meds 1.00 18,559.26 18559.26 07/12/2017 AS Medical Solutions Clinic Meds 1.00 556.79 556.79 CITYCARO Invoice# 758283 Balance Due: 23186.00 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK Submitted To AUG 0 8 2017 Clark Treasurer --Cut and return with payment Please remit 23,186.00 and Make Check Payable to: 09 VISA INVOICE# 758283 IU Health Workplace Services,LLC MASTERCARD 2046 Reliable Pkwy Chicago,IL 60686-0020 ACCOUNT NO Csv EXP CODE DATE Phone: 317-963-1535 SIGNATURE AMOUNT PAID 1 Indiana University Health Workplace Services, LLC 950 North Meridian Street Suite 950 Indianapolis, IN 46204 317-963-1535 Tax ID# 20-0994452 Invoice July 31, 2017 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Onsite Fee's/July 2017 1 Civic Square Carmel,IN 46032- Invoice# 758280 Service Date Description Quanti Charae Receipt A&M Balance 07/01/2017 City of Carmel Sports Performance 1.00 1,800.00 1800.00 Lease 07/01/2017 City of Carmel Clinic Build Out 1.00 2,574.16 2574.16 CITYCARO Invoice# 758280 Balance Due: 4374.16 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK Submitted To AUG 0 8 zou Clark Treasurer Cut ---and----return with payment Please remit 4,374.16 and Make Check Payable to: ❑� VISA INVOICE# 758280 IU Health Workplace Services,LLC ❑ MASTERCARD 2046 Reliable Pkwy Chicago,IL 60686-0020 ACCOUNT NO Csv EXP CODE DATE Phone: 317-963-1535 SIGNATURE AMOUNT PAID Indiana University Health Workplace Services,LLC 950 North Meridian Street Suite 950 (City of Carmel) Indianapolis, IN 46204 317-963-1535 Tax I D# 20-0994452 Invoice July 31, 2017 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Staff Time/July 2017 1 Civic Square Carmel,IN 46032- Invoice# 758281 Service Date Descriptio Quanti Charge Receipt Adiust Balance 07/03/2017 R.N.Staff Time 4.00 255.44 255.44 Mary Weerts 07/03/2017 M.A.Staff Time 5.50 158.62 158.62 Amber Helton 07/03/2017 M.A.Staff Time 11.25 324.45 324.45 Kimberly Pride 07/03/2017 N.P.Staff Time 4.75 551.29 551.29 Tina Nitsos 07/03/2017 MD Staff Time 5.00 901.25 901.25 Dr.Fagan 07/05/2017 R.N.Staff Time 8.00 510.88 510.88 Betty Hartley 07/05/2017 M.A.Staff Time 10.75 310.03 310.03 Kimberly Pride 07/05/2017 N.P.Staff Time 9.25 1,073.56 1073.56 Tina Nitsos 07/06/2017 R.N.Staff Time 4.00 255.44 255.44 Betty Hartley 07/06/2017 M.A.Staff Time 7.50 216.30 216.30 Kimberly Pride 07/06/2017 MD Staff Time 4.00 721.00 721.00 Dr.Fagan 07/07/2017 M.A.Staff Time 5.25 151.41 151.41 Aretis Leslie 07/07/2017 M.A.Staff Time 7.00 201.88 201.88 Kimberly Pride 07/07/2017 Health Coach Staff Time 5.00 329.60 329.60 Marissa Grant 07/07/2017 MD Staff Time 5.00 901.25 901.25 Dr.Fagan 07/10/2017 N.P.Staff Time 4.75 551.29 551.29 Tina Nitsos Submitted To AUG 0 8 2017 Clerk Treasurer Invoice# 758281 (continued)page 2 Service Date Description Quanti Charae Receipt Adiust Balance 07/10/2017 M.A.Staff Time 12.00 346.08 346.08 Kimberly Pride 07/10/2017 R.N.Staff Time 9.50 606.67 606.67 Mischa Cook 07/10/2017 Health Coach Staff Time 7.00 461.44 461.44 Marissa Grant 07/10/2017 MD Staff Time 5.00 901.25 901.25 Dr.Fagan 07/11/2017 R.N.Staff Time 6.00 383.16 383.16 Betty Hartley 07/11/2017 M.A.Staff Time 8.50 245.14 245.14 Kimberly Pride 07/11/2017 MD Staff Time 6.00 1,081.50 1081.50 Dr.Fagan 07/12/2017 R.N.Staff Time 8.50 542.81 542.81 Betty Hartley 07/12/2017 N.P.Staff Time 9.25 1,073.56 1073.56 Tina Nitsos 07/12/2017 M.A.Staff Time 11.50 331.66 331.66 Kimberly Pride 07/13/2017 R.N.Staff Time 5.00 319.30 319.30 Cheretha Benson 07/13/2017 M.A.Staff Time 6.50 187.46 187.46 Kimberly Pride 07/13/2017 MD Staff Time 4.00 721.00 721.00 Dr.Fagan 07/14/2017 R.N.Staff Time 5.75 367.20 367.20 Cheretha Benson 07/14/2017 M.A.Staff Time 6.00 173.04 173.04 Kimberly Pride 07/14/2017 Health Coach Staff Time 5.00 329.60 329.60 Marissa Grant 07/14/2017 MD Staff Time 5.00 901.25 901.25 Dr.Fagan 07/17/2017 MD Staff Time 5.00 901.25 901.25 Dr.Day 07/17/2017 N.P.Staff Time 4.75 551.29 551.29 Tina Nitsos 07/17/2017 M.A.Staff Time 11.25 324.45 324.45 Kimberly Pride 07/17/2017 R.N.Staff Time 9.00 574.74 574.74 Mischa Cook 07/17/2017 Health Coach Staff Time 7.00 461.44 461.44 Marissa Grant 07/18/2017 N.P.Staff Time 6.00 696.36 696.36 Dayna Wilson 07/18/2017 M.A.Staff Time 6.25 180.25 180.25 Kimberly Pride Invoice# 758281 (continued)page 3 Service Date Description Quantity Charge Receipt Adjust Balance 07/19/2017 R.N.Staff Time 8.50 542.81 542.81 Kimberly Smith 07/19/2017 N.P.Staff Time 9.25 1,073.56 1073.56 Tina Nitsos 07/19/2017 M.A.Staff Time 12.25 353.29 353.29 Kimberly Pride 07/20/2017 R.N.Staff Time 4.75 303.34 303.34 Cheretha Benson 07/20/2017 M.A.Staff Time 7.00 201.88 201.88 Kimberly Pride 07/20/2017 MD Staff Time 4.00 721.00 721.00 Dr.Fagan 07/21/2017 R.N.Staff Time 5.75 367.20 367.20 Cheretha Benson 07/21/2017 M.A.Staff Time 6.25 180.25 180.25 Kimberly Pride 07/21/2017 Health Coach Staff Time 5.00 329.60 329.60 Marissa Grant 07/21/2017 MD Staff Time 5.00 901.25 901.25 Dr.Fagan 07/24/2017 N.P.Staff Time 4.75 551.29 551.29 Dayna Wilson 07/24/2017 M.A.Staff Time 11.25 324.45 324.45 Kimberly Pride 07/24/2017 R.N.Staff Time 9.25 590.71 590.71 Mischa Cook 07/24/2017 Health Coach Staff Time 7.00 461.44 461.44 Marissa Grant 07/24/2017 MD Staff Time 5.00 901.25 901.25 Dr.Fagan 07/25/2017 R.N.Staff Time 6.00 383.16 383.16 Betty Hartley 07/25/2017 M.A.Staff Time 6.25 180.25 180.25 Kimberly Pride 07/25/2017 MD Staff Time 6.00 1,081.50 1081.50 Dr.Fagan 07/26/2017 N.P.Staff Time 9.25 1,073.56 1073.56 Eric Afuseh 07/26/2017 M.A.Staff Time 12.25 353.29 353.29 Kimberly Pride 07/27/2017 M.A.Staff Time 7.00 201.88 201.88 Kimberly Pride 07/27/2017 MD Staff Time 4.00 721.00 721.00 Dr.Fagan 07/28/2017 R.N.Staff Time 5.75 367.20 367.20 Cheretha Benson 07/28/2017 M.A.Staff Time 6.00 173.04 173.04 Kimberly Pride Invoice# 758281 (continued)page 4 Service Date Description Quantity Charge $ecejpl A" Balance 07/28/2017 Health Coach Staff Time 5.00 329.60 329.60 Marissa Grant 07/28/2017 MD Staff Time 5.00 901.25 901.25 Dr.Fagan 07/31/2017 N.P.Staff Time 4.75 551.29 551.29 Tina Nitsos 07/31/2017 M.A.Staff Time 9.25 266.77 266.77 Cyndi Moon 07/31/2017 R.N.Staff Time 9.25 590.71 590.71 Betty Hartley 07/31/2017 Health Coach Staff Time 7.00 461.44 461.44 Marissa Grant 07/31/2017 MD Staff Time 5.00 901.25 901.25 Dr.Fagan CITYCARO Invoice# 758281 Balance Due: 36416.10 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK -_Cut and return with payment --------------------- Please remit 36,416.10 and Make Check Payable to: ❑ VISA INVOICE# 758281 IU Health Workplace Services,LLC ❑ MASTERCARD 2046 Reliable Pkwy Chicago,IL 60686-0020 ACCOUNT NO CSV EXP CODE DATE Phone: 317-963-1535 SIGNATURE AMOUNT PAID Indiana University Health Workplace Services,LLC -3:5) 950 North Meridian Street Suite 950 (City of Carmel) Indianapolis, IN 46204 317-963-1535 Tax ID# 20-0994452 Invoice July 31, 2017 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Wellness UDS/July 2017 1 Civic Square Carmel,IN 46032- Invoice# 758278 Service Date Description Quantity Charae Receipt $SJiust Balance 07/11/2017 Quick Read UDS/6panel 15.00 07/19/2017 Quick Read UDS/6panel includes 1.00 15.00 15.00 kit Sc bmilted To AUG 0 8 2017 Clea t reasurer Invoice# 758278(continued)page 2 Service Date Description Quanti Charae Receipt A" 1 alan� 15.00 CITYCARO Invoice# 758278 Balance Due: 105.00 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK -Cut and return with payment -------y----------------- ---- - ------- -------------- -- ------------------- - ------ ---- -----------... Please remit 105.00 and Make Check Payable to: ❑ VISA INVOICE# 758278 IU Health Workplace Services,LLC ❑ MASTERCARD 2046 Reliable Pkwy Chicago,IL 60686-0020 ACCOUNT NO CSV EXP CODE DATE Phone: 317-963-1535 SIGNATURE AMOUNT PAID Indiana University Health Workplace Services, LLC 950 North Meridian Street 1 Suite 950 (City of Carmel) Indianapolis, IN 46204 317-963-1535 Tax ID# 20-0994452 Invoice July 31, 2017 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite PEPM/July 2017 1 Civic Square Carmel,IN 46032- Invoice# 758282 Service Date Description Quantity Charge Receipt dust Balance 07/01/2017 Monthly Wellness PEPM 607.00 1,244.35 1244.35 CITYCARO Invoice# 758282 Balance Due: 1244.35 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK Submitted To AUG 0 8 2011 Clerk Treasurer -- -----------------------and return with payment Please remit 1,244.35 and Make Check Payable to: ❑ VISA INVOICE# 758282 IU Health Workplace Services,LLC ❑ MASTERCARD 2046 Reliable Pkwy Chicago,IL 60686-0020 ACCOUNT NO CSV EXP CODE DATE Phone: 317-963-1535 SIGNATURE AMOUNT PAID / Q n / « « 0 0 0 q & I CD ? @ ® > m m ° n / > G) m \ # 2 / q > � $ q ƒ k k k � O CD E § m O T g -n ? k f k k � 9 m ( I @ t > z m m \ » t Cl. § ? < \ # k ;o / CL 2 3 / 2 n 2 CD $ K 3 7 / / m g 6 ■ ) $ 2 f I / § % 0 / ƒ 2 i aCD D � k k / § 7 } ; « CL ; 2 k 2 f 2 2 2 E gCL CL c - C K 0 9 3 K § = k 3 # 0 k n k 8 a - 0) E CD CL CD k 0 / w _ ■ 0 CL $ 7 f 7 U ; / , o ƒ Z4 _E m m o a cm \ m \ ( , cr �/ _ 0 0 / � (n C } CD ) 0 0 CD ƒ � C o 0 ~ ^ � 06 ° \ \ ( \< �kG\ . , E ) ; 9I & a E D �2 # ; m» > a 2 0 k n CD / j E c \ f G 7 § * ] § = O ƒ J ® O � k q c 0 8 m, CD CD / } o CDOL O $ g « § n a m -n CD ) g CD k ] 0 f CLk K § E @ \ ; % § § 6 ® \ 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 July 31, 2017 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite EAP Services/July 2017 1 Civic Square Carmel,IN 46032- Invoice# 758582 Service Date Description Quanti Charae Receipt Adiust Balance 07/01/2017 EAP Services 639.00 926.55 926.55 CITYCARO Invoice# 758582 Balance Due: 926.55 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK Submtted To AUG 0 S 2017 1 r'Ierk Treasurer ob-16. 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