Loading...
315953 9/12/2017 1 W Cly* �>^, �` CITY OF CARMEL, INDIANA VENDOR: 367222 ONE CIVIC SQUARE IU HEALTH WORKPLACE SERVICES LLCCHECK AMOUNT: $****47,669.41 4; rQ; CARMEL, INDIANA 46032 2046 RELIABLE PKWY CHECK NUMBER: 315953 +.y«oN CHICAGO IL 60686-0020 CHECK DATE: 09/12/17 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1201 4358800 758885 214.00 TESTING FEES 301 5023990 758926 39,676.98 OTHER EXPENSES 301 5023990 758973 135.00 OTHER EXPENSES 301 5023990 759007 1,244.35 OTHER EXPENSES 301 5023990 759008 4,374.16 OTHER EXPENSES 301 5023990 759047 135.89 OTHER EXPENSES 1205 4347500 759129 922.20 GENERAL INSURANCE 301 5023990 759316 966.83 OTHER EXPENSES 0 § n F $ «N) \ § k & m0 O§ q / > m # ? 7 n D I w q , O r q 2 K -4E m 0 % O 7 2 \ ƒ$ OD f 00 m ] O 61) -n/ /m- a o m Z > ;o / k G k & n a � m e � $m C ° r 0 2 0 2 O i / O CD k z $ _ a 9 z > \ o ^ ? 0 \ { =r ® / D _ \ a k 0 r / CD CD k 2 $ 2 ( k $ ƒ + - E k E 7 I K § K J ƒ i 0 k m 2 m e k / $ 7 \ / \ PQ §E 7 � k 4 CD CD 0 CD c/ ; � - � Q > ƒ E Z § (4 m o CL - i% � m 0. CD2 a ,� # - P k 3 � IE \ D / 3 $ ok _ ® Q ( 87 g§ g E ] ƒCD ° E ° q ƒ C \ ) / a # # 7 k 0 Z » _ i �f j / \ �` \k G � , E $ ( -n � §/ k o a 7 2 aF o_ 7 9 ® M - � } $ n / j \ 0 U / O m $ ] / ¢ C Tc o Ch8 = m / } n B 2 / CDM -n c § m ] CD CD / \ { CL > \ f § » q 0 § / 7 § ® k 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 August 31, 2017 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Occupational UDS/Aug. '17 1 Civic Square Carmel,IN 46032- Invoice# 758885 Service Date Description Quantity Charoe Receipt Adiust Balance 07/31/2017 Regulated Drug Screen 15.00 07/25/2017 Regulated Drug Screen 1.00 22.00 22.00 Invoice# 758885(continued)page 2 Service Date Description 214.00 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK FSun3tted To 0 6 2017 Clerk Treasurer w Cut and return with navment 00 N E < < O = y 0 0 0 Z D D o O c n o m --Ar- m ° O r= W = rn m z C a� r Z OL -4 -4 -4 v CA v <O W W Z rn N N f1 co 00 X W 0 0 CD O O V 0 O O 0) O) O V OD V W m O Efl CO). CD (DO) N a a -0 w m 0 0 w ' N m 0 0 0 0 0 0 - n T TI 0Q D Cl) N w N w N w N w N w N a) 0 m o m o m o m o m o m a � %(1 v o o 0 o o o d CL m CL —{ r —i a O n Z R Z O < ,o 69 69 P. ff, K n cn A A CC" O O CO 00 OD w O z S co W co O CT O tC S O< N 3 9 S Z r S j Er Z s m 7. m' c o PL G CD BCL _ 0) O O CD n 7 O 0 x m m 69 C) CD (A CL _ fD 2 nri G 3 N D OM w 3 C/) CL CD CD y a m Co CD 3 o d O CD NN :; 0) CD O ,n, n Q S m o 0) CD @ �0 S = C- a CD CL o O S O 0) N O O d a O a 3 :� ~ Ocr O O C S OD OD OD O 00 00 0 7 = S a Cp O O O W O O O D CD < 0 Q cig o Cn < V -I v v v V m a Po 3 F l< D CD = w 3 n o, z m 0 .d. V V v v v V -n < v '" o g (A) 00 L'Iw co w coo w (0(Yo w coo w acro z 0 � 3 O w a CD 0 0 o w o 0 0 0 0 0 0 co 0 0 _0 m 3 n N O ' -4 O ' O w N 0niD cD n (D n Z n O 14 n � C Q N ^ O D j D D fD c f D p v c co c o N -`� ,r n D � = T o m D C)Q cc 0 O n m `" o C _ m In w N N C ' � t �; CD o o PI m (� 3 W n y g CD v c co CD PA A Z y s c Cl) o o y n CD v CD CD o 0 CD a O N _ cn a L m �' CD a z N C CD N O CL w 69 69 D PF , _ (D CD � E!9 (!f A 69 K S O CO C..) IV - Co < OJi .00i .Cw)) A A vwi fD 00 W co O Cwfl O 0Chi. 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 August 31, 2017 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Wellness UDS/Aug. 2017 1 Civic Square Carmel,IN 46032- Invoice# 758973 Service Date Description Quantity Charge Receipt S Balance 08/21/2017 Quick Read UDS/6panel 15.00 08/08/2017 Quick Read UDS/6panel includes 1.00 15.00 15.00 kit Invoice# 758973 (continued)page 2 Service Date Description Quantity Charae Receipt Adiust Balance 135.00 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK �e Submitted To SEP 0 6 2017 Clerk Treasurer Cut and return with payment chw.� ------------------------------- 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 August 31, 2017 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite PEPM/Aug. 2017 1 Civic Square Carmel,IN 46032- Invoice# 759007 Service Date Description Quantity Charae Receipt �iust Balance 08/01/2017 Monthly Wellness PEPM 607.00 1,244.35 1244.35 CITYCARO Invoice# 759007 Balance Due: 1244.35 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK Subm=itted To SEP 0 6 2017 Clerk Treasurer Cut and return with payment ----------------------------------- ----- Indiana University Health Workplace Services,LLC 950 North Meridian Street Suite 950 Indianapolis, IN 46204 317-963-1535 Tax ID# 20-0994452 Invoice August 31, 2017 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Onsite Fee's/Aug.2017 1 Civic Square Carmel,IN 46032- Invoice# 759008 Service Date Description Quantity Charae Re�eint AO-9 Balance 08/01/2017 City of Carmel Sports Performance 1.00 1,800.00 1800.00 Lease 08/01/2017 City of Carmel Clinic Build Out 1.00 2,574.16 2574.16 CITYCARO Invoice# 759008 Balance Due: 4374.16 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK Submitted To SEP 0 6 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 August 31, 2017 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Misc.Onsite/Aug.2017 1 Civic Square Carmel,IN 46032- Invoice# 759047 Service Date Description Quantity Charae ReceipBalance 05/03/2017 AS Medical Solutions Mail-In Meds 1.00 -5,954.48 -5954.48 1st Quarter 2017 Mail Order Fee Billing Credit 07/01/2017 Onsite Lab Charges 1.00 4,782.16 4782.16 July 2017 Labs 07/31/2017 AS Medical Solutions Clinic Meds 1.00 671.02 671.02 07/31/2017 Video Visit 3.00 147.00 147.00 July 2017 08/04/2017 AS Medical Solutions Clinic Meds 1.00 4.33 4.33 08/07/2017 AS Medical Solutions Clinic Meds 1.00 485.86 485.86 CITYCARO Invoice# 759047 Balance Due: 135.89 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK Submitted To SEP 0 6 2017 Clerk Treasurer 9bW.09P Cut and retum with payment Indiana University Health Workplace Services,LLC 1 950 North Meridian Street Suite 950 (City of Carmel) Indianapolis, IN 46204 317-963-1535 Tax ID# 20-0994452 Invoice August 31, 2017 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Supply Billing/Aug.2017 1 Civic Square Carmel,IN 46032- Invoice# 759316 Service Date Description Quantity Charge Receipt Adiust Balance 08/01/2017 Onsite Operating Supplies 1.00 966.83 966.83 August 2017 Supplies CITYCARO Invoice# 759316 Balance Due: 966.83 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK Subm `_ted To SEP 0 6 2017 Clerk Treasurer O._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 I D# 20-0994452 Invoice August 31, 2017 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Staff Time/Aug.2017 1 Civic Square Carmel,IN 46032- Invoice# 758926 Service Date Description Quantity Charae Receipt Mug Balance 08/01/2017 R.N.Staff Time 5.75 367.20 367.20 Betty Hartley 08/01/2017 M.A.Staff Time 6.50 187.46 187.46 Jeff Mills 08/01/2017 MD Staff Time 6.00 1,081.50 1081.50 Dr.Fagan 08/02/2017 R.N.Staff Time 8.25 526.85 526.85 Betty Hartley 08/02/2017 N.P.Staff Time 8.50 986.51 986.51 Tina Nitsos 08/02/2017 M.A.Staff Time 8.50 245.14 245.14 Kim Clark 08/03/2017 R.N.Staff Time 4.00 255.44 255.44 Betty Hartley 08/03/2017 M.A.Staff Time 4.00 115.36 115.36 Kim Clark 08/03/2017 MD Staff Time 4.00 721.00 721.00 Dr.Fagan 08/04/2017 R.N.Staff Time 5.00 319.30 319.30 Kim Clark 08/04/2017 M.A.Staff Time 5.75 165.83 165.83 Amber Helton 08/04/2017 MD Staff Time 5.00 901.25 901.25 Dr.Fagan 08/07/2017 MD Staff Time 5.00 901.25 901.25 Dr.Fagan 08/07/2017 M.A.Staff Time 9.25 266.77 266.77 Amber Helton 08/07/2017 N.P.Staff Time 4.75 551.29 551.29 Tina Nitsos 08/07/2017 R.N.Staff Time 9.00 574.74 574.74 Kim Clark Invoice# 758926(continued)page 2 Service Date Description Quantity Charge Receipt dust Balance 08/08/2017 MD Staff Time 6.00 1,081.50 1081.50 Dr.Fagan 08/08/2017 M.A.Staff Time 6.25 180.25 180.25 Amber Helton 08/08/2017 R.N.Staff Time 6.00 383.16 383.16 Kim Clark 08/09/2017 M.A.Staff Time 10.50 302.82 302.82 Kimberly Pride 08/09/2017 N.P.Staff Time 9.00 1,044.54 1044.54 Tina Nitsos 08/09/2017 R.N.Staff Time 8.50 542.81 542.81 Kim Clark 08/10/2017 M.A.Staff Time 6.00 173.04 173.04 Kimberly Pride 08/10/2017 MD Staff Time 4.00 721.00 721.00 Dr.Fagan 08/10/2017 R.N.Staff Time 4.00 255.44 255.44 Kim Clark 08/11/2017 M.A.Staff Time 7.00 201.88 201.88 Kimberly Pride 08/11/2017 MD Staff Time 5.00 901.25 901.25 Dr.Fagan 08/11/2017 Health Coach Staff Time 5.00 329.60 329.60 Marissa Grant 08/11/2017 R.N.Staff Time 5.00 319.30 319.30 Jeff Mills 08/14/2017 M.A.Staff Time 11.00 317.24 317.24 Kimberly Pride 08/14/2017 R.N.Staff Time 9.00 574.74 574.74 Jeff Mills 08/14/2017 MD Staff Time 5.00 901.25 901.25 Dr.Fagan 08/14/2017 Health Coach Staff Time 7.00 461.44 461.44 Marissa Grant 08/14/2017 N.P.Staff Time 4.50 522.27 522.27 Tina Nitsos 08/15/2017 M.A.Staff Time 8.00 230.72 230.72 Kimberly Pride 08/15/2017 R.N.Staff Time 6.00 383.16 383.16 Prem Dhawan 08/15/2017 MD Staff Time 6.00 1,081.50 1081.50 Dr.Fagan 08/16/2017 M.A.Staff Time 10.50 302.82 302.82 Kimberly Pride 08/16/2017 R.N.Staff Time 8.50 542.81 542.81 Prem Dhawan 08/16/2017 N.P.Staff Time 8.75 1,015.53 1015.53 Tina Nitsos Invoice# 758926(continued)page 3 Service Date Desc' tion Quantity Charge Receipt Adiust Balance 08/17/2017 M.A.Staff Time 7.25 209.09 209.09 Kimberly Pride 08/17/2017 R.N.Staff Time 4.00 255.44 255.44 Jeff Mills 08/17/2017 MD Staff Time 4.00 721.00 721.00 Dr.Fagan 08/18/2017 M.A.Staff Time 7.00 201.88 201.88 Kimberly Pride 08/18/2017 R.N.Staff Time 5.00 319.30 319.30 Prem Dhawan 08/18/2017 MD Staff Time 5.00 901.25 901.25 Dr.Fagan 08/18/2017 Health Coach Staff Time 5.00 329.60 329.60 Marissa Grant 08/21/2017 Health Coach Staff Time 7.00 461.44 461.44 Marissa Grant 08/21/2017 M.A.Staff Time 11.00 317.24 317.24 Kimberly Pride 08/21/2017 R.N.Staff Time 9.00 574.74 574.74 Jeff Mills 08/21/2017 N.P.Staff Time 4.50 522.27 522.27 Tina Nitsos 08/21/2017 MD Staff Time 5.00 901.25 901.25 Dr.Fagan 08/22/2017 M.A.Staff Time 8.00 230.72 230.72 Kimberly Pride 08/22/2017 M.A.Staff Time 6.00 173.04 173.04 Annalyse Mitchell 08/22/2017 MD Staff Time 6.00 1,081.50 1081.50 Dr.Fagan 08/23/2017 M.A.Staff Time 10.50 302.82 302.82 Kimberly Pride 08/23/2017 N.P.Staff Time 8.75 1,015.53 1015.53 Tina Nitsos 08/24/2017 M.A.Staff Time 6.00 173.04 173.04 Kimberly Pride 08/24/2017 MD Staff Time 4.00 721.00 721.00 Dr.Fagan 08/25/2017 Health Coach Staff Time 5.00 329.60 329.60 Marissa Grant 08/25/2017 M.A.Staff Time 7.00 201.88 201.88 Kimberly Pride 08/25/2017 R.N.Staff Time 5.00 319.30 319.30 Jeff Mills 08/25/2017 MD Staff Time 5.00 901.25 901.25 Dr.Fagan 08/28/2017 Health Coach Staff Time 7.00 461.44 461.44 Marissa Grant Invoice# 758926(continued)page 4 Service Date Description Quantity Charge Receipt Adiuss Balance 08/28/2017 M.A.Staff Time 11.00 317.24 317.24 Kimberly Pride 08/28/2017 R.N.Staff Time 9.00 574.74 574.74 Stacey Neese 08/28/2017 N.P.Staff Time 4.50 522.27 522.27 Tina Nitsos 08/28/2017 MD Staff Time 5.00 901.25 901.25 Dr.Fagan 08/29/2017 M.A.Staff Time 8.00 230.72 230.72 Kimberly Pride 08/29/2017 R.N.Staff Time 6.25 399.13 399.13 Stacey Neese 08/29/2017 MD Staff Time 6.00 1,081.50 1081.50 Dr.Fagan 08/30/2017 M.A.Staff Time 10.50 302.82 302.82 Kimberly Pride 08/30/2017 R.N.Staff Time 9.00 574.74 574.74 Stacey Neese 08/30/2017 N.P.Staff Time 9.00 1,044.54 1044.54 Tina Nitsos 08/31/2017 M.A.Staff Time 6.00 173.04 173.04 Kimberly Pride 08/31/2017 R.N.Staff Time 4.25 271.41 271.41 Stacey Neese 08/31/2017 MD Staff Time 4.00 721.00 721.00 Dr.Fagan CITYCARO Invoice# 758926 Balance Due: 39676.98 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK Submitted To SEP 0 6 2017 Clerk Treasurer Cut and return with payment 0 3 S q f < « /\ O CL ?0 2 m 0 \ Ul > k m r ® k > m 2 ? Q @ m 0 q 2 K w < @ 2 0 % 2 \§ ®2 ƒ f � » k 0 k a- - o m cn ; / \ \ 4 I o - _0 < m ] \ # k ;u 0 m CL ° r z r ® 2 z 0 2 4 > 0 \ \ z q . | £ § / z R L § m / / 0 . c E } } / 0 k 0 G & § 7 - E q - ; / k /\\cn § \ CD 2 CD g 0 \ m FT CL m 2 , a ?L ° E k / k CD @ CL < 0 q J { E o E § - * C. / tC7D a [Z G / m o C f 7 \ƒ \ j \ cr D \ // / \ 0 a ; k w -n < a ° a C: 0 E ] k [m G 2 § 0 2o § & © # # CD ka ; % CD '5 3 § C) f 3 CD �0 o k \D J / » - / �± m ) 9 $o g � a « > Z) CD / / f m f - e SD` F 0 E (D c = r 0 ? # f ] } { C % CD ~ ƒ § $ ° n 0 \ CD m \ \ \ CD \ \ X } [ CD K3§ [ _ > CD2 { = 0 E \ Z \ 11 Indiana University Health Workplace Services,LLC "I-'�s 950 North Meridian Street Suite 950 (City of Carmel) ` Indianapolis, IN 46204 317-963-1535 Tax ID# 20-0994452 Invoice August 31, 2017 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite EAP Services/Aug. 2017 1 Civic Square Carmel,IN 46032- Invoice# 759129 Service Date Description Quantity Charoe Re�eiot A" Balance 08/01/2017 EAP Services 636.00 922.20 922.20 CITYCARO Invoice# 759129 Balance Due: 922.20 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK Submitted To SEP 0 6 2017 Clerk Treasurer Cut and return with payment