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Home My WebLink About321590 02/13/18 s Coq` CITY OF CARMEL, INDIANA VENDOR: 367222 ONE CIVIC SQUARE IU HEALTH WORKPLACE SERVICES LLCCHECK AMOUNT: $"""69,156.31 CARMEL, INDIANA 46032 2046 RELIABLE PKWY CHECK NUMBER: 321590 CHICAGO IL 60686-0020 CHECK DATE; 02/13/18 DEPARTMENT _ ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 301 5023990 761270 21,131.75 OTHER EXPENSES 301 5023990 761317 120.00 OTHER EXPENSES 301 5023990 761318 44,919.42 OTHER EXPENSES 301 5023990 761321 1,260.75 OTHER EXPENSES 301 5023990 761736 1,724.39 OTHER EXPENSES VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) Vendor# 367222 ALL 20 ACCOUNTS PAYABLE VOUCHER IU HEALTH WORKPLACE SERVICES LLC IN SUM OF$ CITY OF CARMEL 2046 RELIABLE PKWY An invoice or bill to be properly itemized must show:kind of service,where performed,dates service rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc. CHICAGO, IL 60686-0020 Payee $69,156.31 Purchase Order# ON ACCOUNT OF APPROPRIATION FOR 301 Medical Fund Terms 301 Medical Fund Date Due PO# ACCT# DATE INVOICE# DESCRIPTION DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT 761317 50-239.90 $120.00 1 hereby certify that the attached invoice(s),or 1/31/18 761317 Jan Onsite Wellness UDS $120.00 301 301 301 301 761318 50-239.90 $44,919.42 bill(s)is(are)true and correct and that the 1/31/18 '761318 Jan Onsite Staff Time $44,919.42 301 1 301 materials or services itemized thereon for 301 1 301 761321 50-239.90 $1,260.75 1/31/18 761321 Jan Onsite PEPM $1,260.75 301 301 which charge is made were ordered and 301 301 761270 50-239.90 $21,131.75 received except 1/31/18 761270 Jan Onsite Misc $21,131.75 301 301 301 301 761736 50-239.90 $1,724.39 1/31/18 761736 Jan Onsite Billing $1,724.39 301 301 301 301 Thursday, February 08,2018 Lamb, Barbara Director I hereby certify that the attached invoice(s),or bill(s),is(are)true and correct and I have audited same in accordance with IC 5-11-10-1.6 ,20— Cost 20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer Indiana University Health Workplace Services, LLC 714 N.Senate Avenue Suite 200 Indianapolis, IN 46202 317-963-1535 Tax ID# 20-0994452 Invoice January 31, 2018 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Wellness UDS/Jan.2018 1 Civic Square Carmel,IN 46032- Invoice# 761317 Service Date Description Quanti Charge Receip Adjust Balance 01/25/2018 Quick Read UDS/6panel 15.00 01/09/2018 Quick Read UDS/6panel includes 1.00 15.00 15.00 kit Invoice# 761317(continued)page 2 Service Date Description Quanti Charge Receipt Adiust Balance 15.00 CITYCARO Invoice# 761317 Balance Due: 120.00 UPDATED INVOICE-PLEASE MAKE PAYMENT TO THE ADDRESS LISTED BELOW WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK Srr�l�r:.e•-.�-s-�-.r.-:sr.:xa�e•:��sossxrr�- Su-Db eel T f_ Q E FEB 0 7 2018 {�WpN1G� Indiana University Health Workplace Services,LLC 714 N.Senate Avenue Suite 200 Indianapolis, IN 46202 317-963-1535 Tax I D# 20-0994452 Invoice January 31, 2018 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Staff Time/Jan.2018 1 Civic Square Carmel,IN 46032- Invoice# 761318 Service Date Description Quanti Charge Recei AW-us-1AW-us-1 Balance 01/02/2018 M.A.Staff Time 9.50 273.98 273.98 Kimberly Pride 01/02/2018 MD Staff Time 5.00 901.25 901.25 Dr.Fagan 01/02/2018 N.P.Staff Time 6.25 725.38 725.38 Tina Nitsos 01/02/2018 R.N.Staff Time 9.75 622.64 622.64 Stacey Neese 01/03/2018 M.A.Staff Time 8.50 245.14 245.14 Kimberly Pride 01/03/2018 N.P.Staff Time 9.25 1,073.56 1073.56 Tina Nitsos 01/03/2018 R.N.Staff Time 10.00 638.60 638.60 Stacey Neese 01/04/2018 Health Coach Staff Time 6.00 395.52 395.52 Kristin Hullett 01/04/2018 M.A.Staff Time 4.75 136.99 136.99 Kimberly Pride 01/04/2018 MD Staff Time 4.00 721.00 721.00 Dr.Fagan 01/04/2018 R.N.Staff Time 4.50 287.37 287.37 Stacey Neese 01/05/2018 Health Coach Staff Time 5.00 329.60 329.60 Kristin Hullett 01/05/2018 M.A.Staff Time 5.75 165.83 165.83 Kimberly Pride 01/05/2018 M.A.Staff Time 6.00 173.04 173.04 Amber Helton 01/05/2018 MD Staff Time 5.00 901.25 901.25 Dr.Fagan 01/05/2018 N.P.Staff Time 5.75 667.35 667.35 Tina Nitsos Invoice# 761318 (continued)page 2 Service Date Description Quant! Charae ReceiptAdiust Balance 01/05/2018 R.N.Staff Time 6.50 415.09 415.09 Stacey Neese 01/08/2018 Health Coach Staff Time 7.00 461.44 461.44 Kristin Hullett 01/08/2018 M.A.Staff Time 9.20 265.33 265.33 Kimberly Pride 01/08/2018 MD Staff Time 5.00 901.25 901.25 Dr.Fagan 01/08/2018 N.P.Staff Time 4.75 551.29 551.29 Tina Nitsos 01/08/2018 R.N.Staff Time 2.00 127.72 127.72 Stacey Neese 01/09/2018 M.A.Staff Time 10.28 296.48 296.48 Kimberly Pride 01/09/2018 MD Staff Time 5.00 901.25 901.25 Dr.Fagan 01/09/2018 N.P.Staff Time 5.50 638.33 638.33 Tina Nitsos 01/09/2018 R.N.Staff Time 4.00 255.44 255.44 Diane Bauman 01/09/2018 R.N.Staff Time 4.80 306.53 306.53 Karol Magyar 01/10/2018 M.A.Staff Time 8.35 240.81 240.81 Kimberly Pride 01/10/2018 N.P.Staff Time 9.50 1,102.57 1102.57 Tina Nitsos 01/10/2018 R.N.Staff Time 10.00 638.60 638.60 Stacey Neese 01/11/2018 M.A.Staff Time 4.40 126.90 126.90 Kimberly Pride 01/11/2018 MD Staff Time 4.00 721.00 721.00 Dr.Fagan 01/11/2018 R.N.Staff Time 5.75 367.20 367.20 Stacey Neese 01/12/2018 Health Coach Staff Time 5.00 329.60 329.60 Kristin Hullett 01/12/2018 M.A.Staff Time 5.60 161.50 161.50 Kimberly Pride 01/12/2018 MD Staff Time 5.00 901.25 901.25 Dr.Fagan 01/12/2018 N.P.Staff Time 5.75 667.35 667.35 Tina Nitsos 01/12/2018 R.N.Staff Time 5.75 367.20 367.20 Stacey Neese 01/15/2018 Health Coach Staff Time 7.00 461.44 461.44 Kristin Hullett 01/15/2018 R.N.Staff Time 2.00 127.72 127.72 Stacey Neese Invoice# 761318(continued)page 3 Service Date DescriptionQuant! Charge Recelp Ad"us Balance 01/16/2018 M.A.Staff Time 8.18. 235.91 235.91 Kimberly Pride 01/16/2018 MD Staff Time 5.00 901.25 901.25 Dr.Fagan 01/16/2018 N.P.Staff Time 5.50 638.33 638.33 Tina Nitsos 01/16/2018 R.N.Staff Time 10.00 638.60 638.60 Stacey Neese 01/17/2018 M.A.Staff Time 8.45 243.70 243.70 Kimberly Pride 01/17/2018 N.P.Staff Time 9.25 1,073.56 1073.56 Tina Nitsos 01/17/2018 R.N.Staff Time 10.00 638.60 638.60 Stacey Neese 01/18/2018 M.A.Staff Time 4.40 126.90 126.90 Kimberly Pride 01/18/2018 MD Staff Time 4.00 721.00 721.00 Dr.Fagan 01/18/2018 R.N.Staff Time 5.00 319.30 319.30 Stacey Neese 01/19/2018 M.A.Staff Time 5.70 164.39 164.39 Kimberly Pride 01/19/2018 M.A.Staff Time 5.90 170.16 170.16 Amber Helton 01/19/2018 MD Staff Time 2.50 450.63 450.63 Dr.Fagan 01/19/2018 N.P.Staff Time 6.50 754.39 754.39 Tina Nitsos 01/19/2018 R.N.Staff Time 6.50 415.09 415.09 Stacey Neese 01/22/2018 Health Coach Staff Time 7.00 461.44 461.44 Kristin Hullett 01/22/2018 M.A.Staff Time 8.70 250.91 250.91 Kimberly Pride 01/22/2018 MD Staff Time 5.00 901.25 901.25 Dr.Fagan 01/22/2018 N.P.Staff Time 4.75 551.29 551.29 Tina Nitsos 01/22/2018 R.N.Staff Time 8.00 510.88 510.88 Stacey Neese 01/23/2018 M.A.Staff Time 8.42 242.83 242.83 Kimberly Pride 01/23/2018 MD Staff Time 5.00 901.25 901.25 Dr.Fagan 01/23/2018 N.P.Staff Time 5.50 638.33 638.33 Tina Nitsos 01/23/2018 R.N.Staff Time 10.25 654.57 654.57 Stacey Neese Invoice# 761318(continued)page 4 Service Date Description Quant! Charae Receipt Must Salance 01/24/2018 M.A.Staff Time 8.80 253.79 253.79 Kimberly Pride 01/24/2018 N.P.Staff Time 9.25 1,073.56 1073.56 Tina Nitsos 01/24/2018 R.N.Staff Time 10.00 638.60 638.60 Stacey Neese 01/25/2018 M.A.Staff Time 4.80 138.43 138.43 Kimberly Pride 01/25/2018 MD Staff Time 4.00 721.00 721.00 Dr.Fagan 01/25/2018 R.N.Staff Time 5.00 319.30 319.30 Stacey Neese 01/26/2018 Health Coach Staff Time 5.00 329.60 329.60 Kristin Hullett 01/26/2018 M.A.Staff Time 5.70 164.39 164.39 Kimberly Pride 01/26/2018 MD Staff Time 5.00 901.25 901.25 Dr.Fagan 01/26/2018 N.P.Staff Time 5.75 667.35 667.35 Tina Nitsos 01/26/2018 R.N.Staff Time 6.00 383.16 383.16 Stacey Neese 01/29/2018 Health Coach Staff Time 7.00 461.44 461.44 Kristin Hullett 01/29/2018 M.A.Staff Time 7.52 216.88 216.88 Kimberly Pride 01/29/2018 MD Staff Time 5.00 901.25 901.25 Dr.Fagan 01/29/2018 N.P.Staff Time 4.75 551.29 551.29 Tina Nitsos 01/29/2018 R.N.Staff Time 9.00 574.74 574.74 Stacey Neese 01/30/2018 M.A.Staff Time 8.42 242.83 242.83 Kimberly Pride 01/30/2018 MD Staff Time 5.00 901.25 901.25 Dr.Fagan 01/30/2018 N.P.Staff Time 5.50 638.33 638.33 Tina Nitsos 01/30/2018 R.N.Staff Time 10.25 654.57 654.57 Stacey Neese 01/31/2018 M.A.Staff Time 8.63 248.89 248.89 Kimberly Pride 01/31/2018 N.P.Staff Time 9.50 1,102.57 1102.57 Tina Nitsos 01/31/2018 R.N.Staff Time 10.00 638.60 638.60 Stacey Neese Invoice# 761318(continued)page 5 Service Date Description Quant! Charge Recelp Adjust Balance CITYCARO Invoice# 761318 Balance Due: 44919.42 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK FEB 0 6 2018 Indiana University Health Workplace Services, LLC 714 N.Senate Avenue Suite 200 Indianapolis, IN 46202 317-963-1535 Tax ID# 20-0994452 Invoice January 31, 2018 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite PEPM/Jan.2018 1 Civic Square Carmel,IN 46032- Invoice# 761321 Service Date Description Quanti Charge Recelp Ad"Us Balance 01/01/2018 Monthly Wellness PEPM 615.00 1,260.75 1260.75 CITYCARO Invoice# 761321 Balance Due: 1260.75 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK T,6 FEB 0 6 2018 p Indiana University Health Workplace Services,LLC _30) 714 N.Senate Avenue Suite 200 Indianapolis, IN 46202 317-963-1535 Tax ID# 20-0994452 Invoice January 31, 2018 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Misc.Onsite/Jan.2018 1 Civic Square Carmel,IN 46032- Invoice# 761270 Service Date Description Quanti Charge Receipt Ad'us Balance 12/01/2017 Onsite Lab Charges 1.00 2,973.76 2973.76 December 2017 Labs 12/21/2017 AS Medical Solutions Mail-In Meds 1.00 7,611.57 7611.57 12/28/2017 AS Medical Solutions Clinic Meds 1.00 1,347.46 1347.46 12/31/2017 Video Visit 5.00 245.00 245.00 December 2017 Video Visits 01/01/2018 Lease Expense 1.00 4,316.05 4316.05 01/01/2018 Building Expenses 1.00 1,086.87 1086.87 01/01/2018 Utility Expenses 1.00 560.73 560.73 01/04/2018 AS Medical Solutions Clinic Meds 1.00 1,855.52 1855.52 01/05/2018 AS Medical Solutions Clinic Meds 1.00 13.12 13.12 01/08/2018 AS Medical Solutions Clinic Meds 1.00 8.84 8.84 01/12/2018 AS Medical Solutions Clinic Meds 1.00 1,112.83 1112.83 CITYCARO Invoice# 761270 Balance Due: 21131.75 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK "! k FEB Of 2018 r'4'i, yy Indiana University Health Workplace Services, LLC 714 N.Senate Avenue Suite 200 Indianapolis, IN 46202 317-963-1535 Tax ID# 20-0994452 Invoice January 31, 2018 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite On-Site Billing/Jan.2018 1 Civic Square Carmel,IN 46032- Invoice# 761736 Service Date DescriptionQuant! Charge Receip Ad'us Balance 01/01/2018 Onsite Facility Operations 1.00 386.71 386.71 January 2018 Facility Services 01/01/2018 Onsite Operating Supplies 1.00 1,337.68 1337.68 January 2018 Supplies CITYCARO Invoice# 761736 Balance Due: 1724.39 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK FEB 0 6 2018 Cut and rehim with navment