318165 11/07/2017 ���*'� CITY OF CARMEL, INDIANA VENDOR: 367222
B i ONE CIVIC SQUARE IU HEALTH WORKPLACE SERVICES LLCCHECK AMOUNT: $""t 80,216.98'
r CARMEL, INDIANA 46032 2046 RELIABLE PKWY CHECK NUMBER: 318165
�Mfrodco. CHICAGO IL 60686-0020 CHECK DATE: 11/07/17
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
301 5023990 759933 195.00 OTHER EXPENSES
1201 4358800 759940 45.00 TESTING FEES
301 5023990 760054 1,248.45 OTHER EXPENSES
301 5023990 760055 4,374.16 OTHER EXPENSES
301 5023990 760121 48,640.02 OTHER EXPENSES
301 5023990 760306 21,173.49 OTHER EXPENSES
301 5023990 760375 4,540.86 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
October 31, 2017
Bill to: Barbara Lamb For: City of Carmel-Onsite
City of Carmel-Onsite Staff Time/Oct. 2017
1 Civic Square
Carmel,IN 46032-
Invoice# 760121
Service Date Description Quantity Charge Receipt A" Balance
10/02/2017 MD Staff Time 5.00 901.25 901.25
Dr.Fagan
10/02/2017 N.P.Staff Time 4.75 551.29 551.29
Tina Nitsos
10/02/2017 M.A.Staff Time 10.00 288.40 288.40
Kimberly Pride
10/02/2017 Health Coach Staff Time 7.00 461.44 461.44
Marissa Grant
10/02/2017 R.N.Staff Time 10.25 654.57 654.57
Stacey Neese
10/03/2017 MD Staff Time 5.00 901.25 901.25
Dr.Fagan
10/03/2017 N.P.Staff Time 5.25 609.32 609.32
Tina Nitsos
10/03/2017 M.A.Staff Time 9.75 281.19 281.19
Kimberly Pride
10/03/2017 R.N.Staff Time 10.75 686.50 686.50
Stacey Neese
10/04/2017 N.P.Staff Time 9.00 1,044.54 1044.54
Tina Nitsos
10/04/2017 M.A.Staff Time 9.25 266.77 266.77
Kimberly Pride
10/04/2017 R.N.Staff Time 10.25 654.57 654.57
Stacey Neese
10/05/2017 MD Staff Time 4.00 721.00 721.00
Dr.Fagan
10/05/2017 M.A.Staff Time 5.25 151.41 151.41
Kimberly Pride
10/05/2017 R.N.Staff Time 6.00 383.16 383.16
Stacey Neese
10/06/2017 MD Staff Time 5.00 901.25 901.25
Dr.Fagan
Invoice# 760121 (continued)page 2
Service Date Description QuanU Chara Receipt Aiust Balance
10/06/2017 N.P.Staff Time 5.50 638.33 638.33
Tina Nitsos
10/06/2017 M.A.Staff Time 6.75 194.67 194.67
Amber Helton
10/06/2017 M.A.Staff Time 6.50 187.46 187.46
Kimberly Pride
10/06/2017 Health Coach Staff Time 5.00 329.60 329.60
Marissa Grant
10/06/2017 R.N.Staff Time 7.50 478.95 478.95
Stacey Neese
10/09/2017 N.P.Staff Time 4.50 522.27 522.27
Tina Nitsos
10/09/2017 N.P.Staff Time 5.00 580.30 580.30
Holly Barna
10/09/2017 M.A.Staff Time 9.25 266.77 266.77
Kimberly Pride
10/09/2017 Health Coach Staff Time 7.00 461.44 461.44
Marissa Grant
10/09/2017 R.N.Staff Time 10.25 654.57 654.57
Stacey Neese
10/10/2017 N.P.Staff Time 10.00 1,160.60 1160.60
Tina Nitsos
10/10/2017 M.A.Staff Time 10.25 295.61 295.61
Kimberly Pride
10/10/2017 R.N.Staff Time 10.25 654.57 654.57
Stacey Neese
10/11/2017 N.P.Staff Time 9.00 1,044.54 1044.54
Tina Nitsos
10/11/2017 M.A.Staff Time 11.75 338.87 338.87
Kimberly Pride
10/11/2017 R.N.Staff Time 11.75 750.36 750.36
Stacey Neese
10/12/2017 MD Staff Time 4.00 721.00 721.00
Dr.Fagan
10/12/2017 M.A.Staff Time 4.25 122.57 122.57
Karol Magyar
10/12/2017 R.N.Staff Time 7.50 478.95 478.95
Stacey Neese
10/13/2017 MD Staff Time 5.00 901.25 901.25
Dr.Fagan
10/13/2017 M.A.Staff Time 5.00 144.20 144.20
Amy Bandajas
10/13/2017 N.P.Staff Time 5.50 638.33 638.33
Tina Nitsos
10/13/2017 M.A.Staff Time 6.25 180.25 180.25
Amber Helton
10/13/2017 Health Coach Staff Time 5.00 329.60 329.60
Marissa Grant
Invoice# 760121 (continued)page 3
Service Date Description Quantity Charae Receipt A&W Balance
10/13/2017 R.N.Staff Time 8.75 558.78 558.78
Stacey Neese
10/16/2017 MD Staff Time 5.00 901.25 901.25
Dr.Fagan
10/16/2017 N.P.Staff Time 4.75 551.29 551.29
Tina Nitsos
10/16/2017 M.A.Staff Time 10.50 302.82 302.82
Kimberly Pride
10/16/2017 R.N.Staff Time 9.50 606.67 606.67
Stacey Neese
10/16/2017 Health Coach Staff Time 9.00 593.28 593.28
Marissa Grant
10/17/2017 MD Staff Time 5.00 901.25 901.25
Dr.Fagan
10/17/2017 N.P.Staff Time 6.75 783.41 783.41
Tina Nitsos
10/17/2017 M.A.Staff Time 9.00 259.56 259.56
Kimberly Pride
10/17/2017 R.N.Staff Time 10.25 654.57 654.57
Stacey Neese
10/17/2017 Health Coach Staff Time 3.00 197.76 197.76
Marissa Grant
10/18/2017 N.P.Staff Time 9.00 1,044.54 1044.54
Tina Nitsos
10/18/2017 M.A.Staff Time 4.75 136.99 136.99
Kimberly Pride
10/18/2017 R.N.Staff Time 5.50 351.23 351.23
Stacey Neese
10/19/2017 MD Staff Time 4.00 721.00 721.00
Dr.Fagan
10/19/2017 R.N.Staff Time 4.00 255.44 255.44
Stacey Neese
10/19/2017 M.A.Staff Time 4.00 115.36 115.36
Robert Steitz
10/20/2017 M.A.Staff Time 5.25 151.41 151.41
Cynthia Reid
10/20/2017 MD Staff Time 5.00 901.25 901.25
Dr.Fagan
10/20/2017 N.P.Staff Time 5.50 638.33 638.33
Tina Nitsos
10/20/2017 R.N.Staff Time 6.25 399.13 399.13
Stacey Neese
10/20/2017 M.A.Staff Time 5.00 144.20 144.20
Robert Steitz
10/23/2017 MD Staff Time 5.00 901.25 901.25
Dr.Fagan
10/23/2017 N.P.Staff Time 4.75 551.29 551.29
Tina Nitsos
Invoice# 760121 (continued)page 4
Service Date Description Quanti Charge Receipt Adiust Balance
10/23/2017 M.A.Staff Time 9.25 266.77 266.77
Kimberly Pride
10/23/2017 R.N.Staff Time 10.25 654.57 654.57
Stacey Neese
10/24/2017 MD Staff Time 5.00 901.25 901.25
Dr.Fagan
10/24/2017 N.P.Staff Time 5.75 667.35 667.35
Tina Nitsos
10/24/2017 M.A.Staff Time 9.00 259.56 259.56
Kimberly Pride
10/24/2017 R.N.Staff Time 10.00 638.60 638.60
Stacey Neese
10/25/2017 N.P.Staff Time 9.00 1,044.54 1044.54
Tina Nitsos
10/25/2017 M.A.Staff Time 9.50 273.98 273.98
Kimberly Pride
10/25/2017 R.N.Staff Time 10.00 638.60 638.60
Stacey Neese
10/25/2017 M.A.Staff Time 3.00 86.52 86.52
Kathleen Visker
10/26/2017 MD Staff Time 4.00 721.00 721.00
Dr.Fagan
10/26/2017 M.A.Staff Time 5.00 144.20 144.20
Kimberly Pride
10/26/2017 R.N.Staff Time 6.00 383.16 383.16
Stacey Neese
10/27/2017 MD Staff Time 5.00 901.25 901.25
Dr.Fagan
10/27/2017 N.P.Staff Time 5.75 667.35 667.35
Tina Nitsos
10/27/2017 M.A.Staff Time 6.25 180.25 180.25
Kimberly Pride
10/27/2017 R.N.Staff Time 6.25 399.13 399.13
Stacey Neese
10/27/2017 M.A.Staff Time 6.00 173.04 173.04
Amber Helton
10/27/2017 Health Coach Staff Time 5.00 329.60 329.60
Marissa Grant
10/30/2017 MD Staff Time 5.00 901.25 901.25
Dr.Fagan
10/30/2017 N.P.Staff Time 4.75 551.29 551.29
Tina Nitsos
10/30/2017 M.A.Staff Time 9.25 266.77 266.77
Kimberly Pride
10/30/2017 R.N.Staff Time 10.00 638.60 638.60
Stacey Neese
10/30/2017 Health Coach Staff Time 5.00 329.60 329.60
Marissa Grant
Invoice# 760121 (continued)page 5
Service Date Description Quantity Charge Receipt Aiust Balance
10/31/2017 MD Staff Time 5.00 901.25 901.25
Dr.Fagan
10/31/2017 N.P.Staff Time 5.75 667.35 667.35
Tina Nitsos
10/31/2017 M.A.Staff Time 9.00 259.56 259.56
Kimberly Pride
10/31/2017 R.N.Staff Time 10.00 638.60 638.60
Stacey Neese
CITYCARO Invoice# 760121 Balance Due: 48640.02
MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE
INVOICE#ON CHECK
Submitted To
NOV 0 7 2017
Clerk Treasurer
C 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
October 31, 2017
Bill to: Barbara Lamb For: City of Carmel-Onsite
City of Carmel-Onsite Onsite Fee's/Oct.2017
1 Civic Square
Carmel,IN 46032-
Invoice# 760055
Service Date Description QuapjiYy Charge Receipt Al Balance
10/01/2017 City of Cannel Sports Performance 1.00 1,800.00 1800.00
Lease
10/01/2017 City of Carmel Clinic Build Out 1.00 2,574.16 2574.16
CITYCARO Invoice# 760055 Balance Due: 4374.16
MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE
INVOICE#ON CHECK
N0V 0 7 2017
Clerk Treasurer
w 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
October 31, 2017
Bill to: Barbara Lamb For: City of Cannel-Onsite
City of Carmel-Onsite PEPM/Oct.2017
1 Civic Square
Carmel,IN 46032-
Invoice# 760054
Service Date Descriytion Quanti Charce Receipt Adiust Balance
10/01/2017 Monthly Wellness PEPM 609.00 1,248.45 1248.45
CITYCARO Invoice# 760054 Balance Due: 1248.45
MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE
INVOICE#ON CHECK
Subm-it-ted To
NOV 0 7 2017
Clerk Treasurer
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
October 31, 2017
Bill to: Barbara Lamb For: City of Carmel-Onsite
City of Carmel-Onsite Supply Billing/Oct.2017
1 Civic Square
Carmel,IN 46032-
Invoice# 760375
Service Date Description Quantity Charge Receipt Adjust Balance
10/01/2017 Onsite Operating Supplies 1.00 4,540.86 4540.86
October 2017 Supplies
CITYCARO Invoice# 760375 Balance Due: 4540.86
MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE
INVOICE#ON CHECK
Subm-i ted To
NOV 0 7 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
October 31, 2017
Bill to: Barbara Lamb For: City of Carmel-Onsite
City of Carmel-Onsite Misc.Onsite/Oct.2017
1 Civic Square
Carmel,IN 46032-
Invoice# 760306
Service Date Description Quantity Charae ReceipBalance
09/01/2017 Onsite Lab Charges 1.00 2,889.18 2889.18
September 2017 Labs
09/18/2017 AS Medical Solutions Clinic Meds 1.00 534.58 534.58
09/20/2017 AS Medical Solutions Clinic Meds 1.00 791.34 791.34
09/26/2017 AS Medical Solutions Mail-In Meds 1.00 4,544.64 4544.64
10/01/2017 Miscellaneous Charge 1.00 3,500.00 3500.00
IT Infrastructure-New Premises
10/05/2017 AS Medical Solutions Mail-In Meds 1.00 3,282.96 3282.96
10/05/2017 AS Medical Solutions Clinic Meds 1.00 1,501.51 1501.51
10/06/2017 AS Medical Solutions Clinic Meds 1.00 956.15 956.15
10/13/2017 AS Medical Solutions Mail-In Meds 1.00 1,970.32 1970.32
10/19/2017 AS Medical Solutions Clinic Meds 1.00 1,202.81 1202.81
CITYCARO Invoice# 760306 Balance Due: 21173.49
MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE
INVOICE#ON CHECK
Subm=.. "ted To
NOV 0 7 2017
Clerk, Treasurer
r.»an,t mn,m with payment
-----------------------------------------------------------------
Indiana University Health Workplace Services,LLC
'3P) 950 North Meridian Street
Suite 950 (City of Carmel)
Indianapolis, IN 46204
317-963-1535
Tax ID# 20-0994452
Invoice
October 31, 2017
Bill to: Barbara Lamb For: City of Carmel-Onsite
City of Carmel-Onsite Wellness UDS/Oct. 2017
1 Civic Square
Carmel,IN 46032-
Invoice# 759933
Service Date Description Quantity Charae Receipt Adiust Balance
10/11/2017 Quick Read UDS/6panel includes
15.00
10/05/2017 Quick Read UDS/6panel includes 1.00 15.00 15.00
kit
Invoice# 759933 (continued)page 2
Service Date Description
195.00
MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE
INVOICE#ON CHECK
Submi"i ted To
NOV 0 7 2017
Clerk Treasurer
--
Cut and retum with payment
----------------------------------------------------------------------------------------------------------
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Indiana University Health Workplace Services,LLC
b" 950 North Meridian Street
Suite 950 (City of Carmel)
Indianapolis, IN 46204
317-963-1535
Tax ID# 20-0994452
Invoice
October 31, 2017
Bill to: Barbara Lamb For: City of Carmel-Onsite
City of Carmel-Onsite Occupational UDS/Oct.
1 Civic Square
Carmel,IN 46032-
Invoice# 759940
Service Date Description Quantity Charge Receipt Adiust Balance
10/13/2017 Quick Read UDS/6panel includes 1.00
45.00
MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE
INVOICE#ON CHECK
SublrnlsI.-ted To
NOV 0 7 2017
Clerk Treasurer
Cut and return with payment