316818 10/6/2017 CITY OF CARMEL, INDIANA VENDOR: 367222
ONE CIVIC SQUARE IU HEALTH WORKPLACE SERVICES LLCCHECK AMOUNT: S""'68,860.80'
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CARMEL, INDIANA 46032 2046 RELIABLE PKWY CHECK NUMBER: 316818
CHICAGO IL 60686-0020 CHECK DATE: 10/06/17
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
301 5023990 759429 37,874.31 OTHER EXPENSES
301 5023990 759458 90.00 OTHER EXPENSES
301 5023990 759469 23,505.64 OTHER EXPENSES
301 5023990 759524 4,374.16 OTHER EXPENSES
301 5023990 759772 1,307.90 OTHER EXPENSES
301 5023990 759796 1,708.79 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
September 30, 2017
Bill to: Barbara Lamb For: City of Carmel-Onsite
City of Carmel-Onsite PEPM/Sept. 2017
1 Civic Square
Carmel,IN 46032-
Invoice# 759772
Service Date Description Quantity Charae Receipt A�iust Balance
09/01/2017 Monthly Wellness PEPM 638.00 1,307.90 1307.90
CITYCARO Invoice# 759772 Balance Due: 1307.90
MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE
INVOICE#ON CHECK
Subm'Z4ted To
OCT 0 3 2011
Clark Treasurer
Cut and return with payment
--------------- -------------------------------------------------------------------------------------------------------------------------
30) 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
September 30, 2017
Bill to: Barbara Lamb For: City of Carmel-Onsite
City of Carmel-Onsite Wellness UDS/Sept.2017
1 Civic Square
Carmel,IN 46032-
Invoice# 759458
Service Date Description Quanti Charge ReceipBalance
09/14/2017 Quick Read UDS/6panel includes 1.00 15.00 15.00
kit
15.00
Invoice# 759458(continued)page 2
Service Date Description Quanb Charae Receipt Adjut Balance
CITYCARO Invoice# 759458 Balance Due: 90.00
MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE
INVOICE#ON CHECK
SubmItted To
OCT 0 3 2017
Clerk Treasurer
Cut and return with payment
Indiana University Health Workplace Services, LLC
3,) 950 North Meridian Street
Suite 950 (City of Carmel)
Indianapolis, IN 46204
317-963-1535
Tax ID# 20-0994452
Invoice
September 30, 2017
Bill to: Barbara Lamb For: City of Carmel-Onsite
City of Carmel-Onsite Staff Time/Sept.2017
1 Civic Square
Carmel,IN 46032-
Invoice# 759429
Service Date Descril2tion Quantity Charae ReceipBalance
09/01/2017 MD Staff Time 5.00 901.25 901.25
Dr.Fagan
09/01/2017 Health Coach Staff Time 5.00 329.60 329.60
Marissa Grant
09/01/2017 M.A.Staff Time 3.50 100.94 100.94
Kimberly Pride
09/01/2017 M.A.Staff Time 7.25 209.09 209.09
Amber Helton
09/05/2017 MD Staff Time 6.00 1,081.50 1081.50
Dr.Fagan
09/05/2017 R.N.Staff Time 6.00 383.16 383.16
Cyndi Moon
09/05/2017 M.A.Staff Time 8.50 245.14 245.14
Kimberly Pride
09/06/2017 R.N.Staff Time 8.50 542.81 542.81
Cyndi Moon
09/06/2017 N.P.Staff Time 9.75 1,131.59 1131.59
Tina Nitsos
09/06/2017 M.A.Staff Time 10.50 302.82 302.82
Kimberly Pride
09/07/2017 MD Staff Time 4.00 721.00 721.00
Dr.Fagan
09/07/2017 Health Coach Staff Time 4.00 263.68 263.68
Tania McNab
09/07/2017 R.N.Staff Time 4.25 271.41 271.41
Karol Magyar
09/07/2017 M.A.Staff Time 6.25 180.25 180.25
Kimberly Pride
09/08/2017 MD Staff Time 5.00 901.25 901.25
Dr.Fagan
09/08/2017 Health Coach Staff Time 4.00 263.68 263.68
Tania McNab
Invoice# 759429(continued)page 2
Service Date Description Quanti Charae Receipt Adiust Balance
09/08/2017 M.A.Staff Time 7.00 201.88 201.88
Kimberly Pride
09/08/2017 M.A.Staff Time 8.25 237.93 237.93
Amber Helton
09/11/2017 MD Staff Time 5.00 901.25 901.25
Dr.Fagan
09/11/2017 R.N.Staff Time 10.00 638.60 638.60
Stacey Neese
09/11/2017 N.P.Staff Time 4.50 522.27 522.27
Tina Nitsos
09/11/2017 Health Coach Staff Time 7.00 461.44 461.44
Marissa Grant
09/11/2017 M.A.Staff Time 10.00 288.40 288.40
Kimberly Pride
09/12/2017 MD Staff Time 6.00 1,081.50 1081.50
Dr.Fagan
09/12/2017 R.N.Staff Time 7.00 447.02 447.02
Stacey Neese
09/12/2017 N.P.Staff Time 1.00 116.06 116.06
Tina Nitsos
09/12/2017 M.A.Staff Time 6.75 194.67 194.67
Kimberly Pride
09/13/2017 R.N.Staff Time 9.75 622.64 622.64
Stacey Neese
09/13/2017 N.P.Staff Time 8.75 1,015.53 1015.53
Tina Nitsos
09/13/2017 M.A.Staff Time 10.25 295.61 295.61
Kimberly Pride
09/14/2017 MD Staff Time 4.00 721.00 721.00
Dr.Fagan
09/14/2017 R.N.Staff Time 5.00 319.30 319.30
Stacey Neese
09/14/2017 M.A.Staff Time 6.00 173.04 173.04
Kimberly Pride
09/15/2017 MD Staff Time 5.00 901.25 901.25
Dr.Fagan
09/15/2017 R.N.Staff Time 5.75 367.20 367.20
Stacey Neese
09/15/2017 Health Coach Staff Time 2.00 131.84 131.84
Marissa Grant
09/15/2017 M.A.Staff Time 6.50 187.46 187.46
Kimberly Pride
09/18/2017 N.P.Staff Time 4.50 522.27 522.27
Tina Nitsos
09/18/2017 M.A.Staff Time 10.00 288.40 288.40
Kimberly Pride
09/18/2017 R.N.Staff Time 10.00 638.60 638.60
Stacey Neese
Invoice# 759429(continued)page 3
Service Date Description QuantJ Charae Receipt dust Balance
09/18/2017 Health Coach Staff Time 7.00 461.44 461.44
Marissa Grant
09/18/2017 MD Staff Time 5.00 901.25 901.25
Dr.Fagan
09/19/2017 R.N.Staff Time 7.00 447.02 447.02
Stacey Neese
09/19/2017 M.A.Staff Time 7.00 201.88 201.88
Kimberly Pride
09/19/2017 MD Staff Time 6.00 1,081.50 1081.50
Dr.Fagan
09/20/2017 N.P.Staff Time 9.00 1,044.54 1044.54
Tina Nitsos
09/20/2017 M.A.Staff Time 10.50 302.82 302.82
Kimberly Pride
09/20/2017 R.N.Staff Time 9.75 622.64 622.64
Stacey Neese
09/21/2017 M.A.Staff Time 6.25 180.25 180.25
Kimberly Pride
09/21/2017 R.N.Staff Time 5.00 319.30 319.30
Stacey Neese
09/21/2017 MD Staff Time 4.00 721.00 721.00
Dr.Fagan
09/22/2017 M.A.Staff Time 7.00 201.88 201.88
Kimberly Pride
09/22/2017 R.N.Staff Time 5.75 367.20 367.20
Stacey Neese
09/22/2017 Health Coach Staff Time 5.00 329.60 329.60
Marissa Grant
09/22/2017 MD Staff Time 5.00 901.25 901.25
Dr.Fagan
09/25/2017 N.P.Staff Time 4.50 522.27 522.27
Tina Nitsos
09/25/2017 M.A.Staff Time 10.00 288.40 288.40
Kimberly Pride
09/25/2017 R.N.Staff Time 10.00 638.60 638.60
Stacey Neese
09/25/2017 Health Coach Staff Time 7.00 461.44 461.44
Marissa Grant
09/25/2017 MD Staff Time 5.00 901.25 901.25
Dr.Fagan
09/26/2017 M.A.Staff Time 6.75 194.67 194.67
Kimberly Pride
09/26/2017 R.N.Staff Time 7.00 447.02 447.02
Stacey Neese
09/26/2017 MD Staff Time 6.00 1,081.50 1081.50
Dr.Fagan
09/27/2017 N.P.Staff Time 9.00 1,044.54 1044.54
Tina Nitsos
Invoice# 759429(continued)page 4
Service Date Description Quantity Charae Receipt A6A Balance
09/27/2017 M.A.Staff Time 10.25 295.61 295.61
Kimberly Pride
09/27/2017 R.N.Staff Time 9.75 622.64 622.64
Stacey Neese
09/28/2017 N.P.Staff Time 3.75 435.23 435.23
Tina Nitsos
09/28/2017 M.A.Staff Time 6.00 173.04 173.04
Kimberly Pride
09/28/2017 R.N.Staff Time 5.00 319.30 319.30
Stacey Neese
09/28/2017 MD Staff Time 4.00 721.00 721.00
Dr.Fagan
09/29/2017 N.P.Staff Time 6.50 754.39 754.39
Tina Nitsos
09/29/2017 M.A.Staff Time 6.50 187.46 187.46
Kimberly Pride
09/29/2017 R.N.Staff Time 5.75 367.20 367.20
Stacey Neese
09/29/2017 Health Coach Staff Time 5.00 329.60 329.60
Marissa Grant
09/29/2017 MD Staff Time 5.00 901.25 901.25
Dr.Fagan
CITYCARO Invoice# 759429 Balance Due: 3787431
MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE
INVOICE#ON CHECK
Subm"'Tted To
OCT 03 2017
Clerk Treasurer
Cut and return with payment
----------------------------------------------------------------------------
Indiana University Health Workplace Services, LLC
950 North Meridian Street
3� Suite 950 (City of Carmel)
Indianapolis, IN 46204
317-963-1535
Tax ID# 20-0994452
Invoice
September 30, 2017
Bill to: Barbara Lamb For: City of Carmel-Onsite
City of Carmel-Onsite Supply Billing/Sept. 2017
1 Civic Square
Carmel,IN 46032-
Invoice# 759796
Service Date Description Quanti Charge Receipt Adiust Balance
09/01/2017 Onsite Operating Supplies 1.00 1,708.79 1708.79
September 2017 Supplies
CITYCARO Invoice# 759796 Balance Due: 1708.79
MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE
INVOICE#ON CHECK
Submi *t�'7ToOCT 0 3 2
Clerk Tr asurear
_ 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
September 30, 2017
Bill to: Barbara Lamb For: City of Carmel-Onsite
City of Carmel-Onsite Onsite Fee's/Sept. 2017
1 Civic Square
Carmel,IN 46032-
Invoice# 759524
Service Date Description Quanti Charae Receipt $SJiust Balance
09/01/2017 City of Carmel Sports Performance 1.00 1,800.00 1800.00
Lease
09/01/2017 City of Carmel Clinic Build Out 1.00 2,574.16 2574.16
CITYCARO Invoice# 759524 Balance Due: 4374.16
MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE
INVOICE#ON CHECK
Submitted To
OCT 0 3 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
September 30, 2017
Bill to: Barbara Lamb For: City of Carmel-Onsite
City of Carmel-Onsite Misc.Onsite/Sept. 2017
1 Civic Square
Carmel,IN 46032-
Invoice# 759469
Service Date Description Quanti Cha[ge ChargeReceipt Adiust Balance
05/03/2017 AS Medical Solutions Mail-In Meds 1.00 5,954.48 5954.48
1st Qtr 2017 Mail Order Fee
05/03/2017 AS Medical Solutions Mail-In Meds 1.00 5,954.48 5954.48
I st Qtr 2017 Mail Order Fee(Reverse Credit from last
month)
08/01/2017 Onsite Lab Charges 1.00 3,348.37 3348.37
August 2017 Labs
08/17/2017 AS Medical Solutions Clinic Meds 1.00 388.04 388.04
08/22/2017 AS Medical Solutions Clinic Meds 1.00 106.72 106.72
08/22/2017 AS Medical Solutions Mail-In Meds 1.00 5,287.02 5287.02
08/23/2017 AS Medical Solutions Clinic Meds 1.00 668.99 668.99
08/29/2017 AS Medical Solutions Clinic Meds 1.00 11.10 11.10
08/30/2017 AS Medical Solutions Clinic Meds 1.00 1,171.87 1171.87
08/31/2017 Video Visit 1.00 49.00 49.00
August 2017
09/11/2017 AS Medical Solutions Clinic Meds 1.00 565.57 565.57
CITYCARO Invoice# 759469 Balance Due: 23505.64
MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE
INVOICE#ON CHECK
Submitlted To
OCT 03 2017
Clerk Treasurer_ _ Cut and return with payment