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317314 10/11/17
CITY OF CARMEL, INDIANA VENDOR: 367222 o ONE CIVIC SQUARE IU HEALTH WORKPLACE SERVICES LLCCHECK AMOUNT: S""'"'"970.10' CARMEL, INDIANA 46032 2046 RELIABLE PKWY CHECK NUMBER: 317314 �+ai Tow�o CHICAGO IL 60686-0020 CHECK DATE: 10/11/17 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1201 4358800 759435 45.00 TESTING FEES 1205 4347500 759771 925.10 GENERAL INSURANCE n m 0 ƒ « I \ 2 z 0 P. OL m 0 7 ^ 0 q r # 2 ( n D = 9 q O e q 2 K w < E m O O % ( \ ƒ $ f ( § m ] O $ it § # q f D ( m � q CD \ q 2 m E X \ \ CL § / k OL ° c E � 2 ? 0 2 J > -n O /_ n \ q (D 8 z / J_ a % 3 E # D § ( % c § % m 0 E E 2 / CD� \ & ; k q A CD § 7 - rCL cn d 2 Q § [ / k F 0 m - Z 5 § co 0 % 7 8 \ 7 % 7 " / 9 m \ 0) k / 00 2 , E � $ 2 ƒ § ° ® 3 cn 0 7 Q: K m c i [ 7 CD 0. § f � � } 2 OL mcn - k CD \ D / 0a ) \ 7 k ) -n z a m 0 ca /} CD k / ƒ �0 o k �ƒ a #) * \ F Z «/ \ \� 0 D f_ £ / ; )/ Cl) & a « 0 �E D / / \ \ / \ M � o g g E / a \ r O 7 S f z \ ] i ( ; c 0 c / § cr CD CDo \ / $ § 0 ƒ C: ; , ] CD \ \ ( [ > \ f k 6s § } g / C) § ® k —� 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 Occupational DS/Sept.2017 1 Civic Square Carmel,IN 46032- Invoice# 759435 Service Date Description Quantity Charae Receipt ASl1Sd.SS Balance 08/09/2017 Evidential Breath-Reg. 45.00 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK Submitted OCT 0 3 Clerk Treasurer Cut and return with payment / Q \ 6 « ■ mT O I AIS O ƒ § 2 2 g = m 0 c e ° ^ > $ m r # ? \ 0 \ I w x = O e k q 2 / -Ln 4CD z k -04 e m ® « A 9 # t k r, A > » $ 2 / } _ m 3 . / , ƒ ƒ / 3 ¢ / 7 CA ® k 2 g k ( k w a 2 { te c / / O ƒ \ § | CD w & e L7 - 2 # CD { ( k @ 3 Z. 7 / CY § m C mo t ; -n o ƒ A § 2 R _ CD G - - m / 2 / 2 CL / { 5 k / m g m - & / / / a % \ § 0) / ) , \ \ k = cn 7 g 7 [ { _ \ : 0 w CL 7 * ƒ § I 3 (D 0 7 � kI © 2 \ 7 2 m o z , - \/ § j L ( / \Z # D $ ) / 7 © � ) -n < 0 // 7 0§ 0 CD 2 � � U ^ * \ 0 > § k� \ CD \ \ Z \< f E 2 90 \ Tr 0 > 2� = CD a D 21 R & a « § fCD § f } C z 2 / k / j E / n r X 7 § ƒ z CD ] i \ ƒ C # q c E / CL ° CD CD M CD 0 / § m ] k \ / / [ \ f 2 k50, & ® § o w 7 Indiana University Health Workplace Services,LLC 950 North Meridian Street 2 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 EAP Services/Sept.2017 1 Civic Square Carmel,IN 46032- Invoice# 759771 Service Date Description Quanti Charae Receipt Aiust Balance 09/01/2017 EAP Services 638.00 925.10 925.10 CITYCARO Invoice# 759771 Balance Due: 925.10 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 �� -------------------- -------------------------------------------------------------------------- --