HomeMy WebLinkAbout322745 03/12/18 i
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CITY OF CARMEL, INDIANA VENDOR: 367222'
i'• ONE CIVIC SQUARE IU HEALTH WORKPLACE SERVICES LLCCHECK AMOUNT: $....***992.35*
CARMEL, INDIANA 46032 2046 RELIABLE PKWY CHECK NUMBER: 322745
9M«oN :� CHICAGO IL 60686-0020 CHECK DATE: 03/12/18
DEPARTMENT ACCOUNT PO NUMBER_ INVOICE NUMBER AMOUNT; DESCRIPTION
1201 4358800 761997 60.00 TESTING FEES
1205 4347500 762095 932.35 GENERAL INSURANCE
_ j
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
Vendor# 367222 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
IU HEALTH WORKPLACE SERVICES LLC IN SUM OF$ 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
$60.00
Purchase Order#
ON ACCOUNT OF APPROPRIATION FOR
Human Resources Terms
Date Due
PO# ACCT# DATE INVOICE# DESCRIPTION
DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT
761997 43-588.00 $60.00 1 hereby certify that the attached invoice(s),or 2/28/18 761997 $60.00
1201 101 1201 101
bill(s)is(are)true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
Monday, March 05,2018
Lamb, Barbara
Director
I hereby certify that the attached invoice(s),or bill(s),is(are)true and correct and I have
audited same in accordance with IC 5-11-10-1.6
,20
Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer
Indiana University Health Workplace Services,LLC
Sg 714 N.Senate Avenue
Suite 200
Indianapolis, IN 46202
317-963-1535
Tax ID# 20-0994452
Invoice
February 28, 2018
Bill to: Barbara Lamb For: City of Carmel-Onsite
City of Carmel-Onsite Occupational UDS/Feb.2018
1 Civic Square
Carmel,IN 46032-
Invoice# 761997
Service Date Description Quanti Charge Recei Ad"US Balance
02/27/2018 Quick Read UDS/6panel includes 1.00 15.00 15.00
kit
02/27/2018 Confirmation for Quick Read
60.00
MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE
INVOICE#ON CHECK
FKPKP :1 .1 T_r ^
i1+ N
n
MAR 0 5 2018
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VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
Vendor# 367222 ?
ALLOWED 0ACCOUNTS PAYABLE VOUCHER
IU HEALTH WORKPLACE SERVICES LLC IN suns of$ 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 60.686-0020
Payee
$932.35
ON ACCOUNT OF APPROPRIATION FOR Purchase Order#
General Administration Terms
Date Due
PO# ACCT# DATE INVOICE# DESCRIPTION
DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT
762095 43-475.00 $932.35 1 hereby certify that the attached invoice(s),or 2/28/18 762095 EAP Services $932.35
1205 101 1205 101:
bill(s)is(are)true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
Monday, March 05,2018
Crider,James �'7�
Administration
I hereby certify that the attached invoice(s),or bill(s),is(are)true and correct and 1 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
1�3 714 N.Senate Avenue
Suite 200
)2o5 Indianapolis, IN 46202
317-963-1535
Tax ID# 20-0994452
Invoice
February 28, 2018
Bill to: Barbara Lamb For: City of Carmel-Onsite
City of Carmel-Onsite EAP Services/Feb. 2018
1 Civic Square
Carmel,IN 46032-
Invoice# 762095
Service Date Description Quant! Charae R c i A 'u Balance
02/01/2018 EAP Services 643.00 932.35 932.35
CITYCARO Invoice# 762095 Balance Due: 932.35
MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE
INVOICE#ON CHECK
PEAR 0 5 2018