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Home My WebLink About323223 03/21/18 CITY OF CARMEL, INDIANA VENDOR: 00350364 ® ONE CIVIC SQUARE PUBLIC SAFETY MEDICAL SERVICES CHECK AMOUNT: S'"`"7,385.33' CARMEL, INDIANA 46032 324 E NEW YORK ST SUITE 300 CHECK NUMBER: 323223 vM�TON��; INDIANAPOLIS IN 46204 CHECK DATE: 03/21/18 DEPARTMENT ACCOUNT PO NUMBER. INVOICE NUMBER AMOUNT DESCRIPTION, 1110 4340701 100944 0032502 7,385.33 OFFICER PHYSICALS VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) Vendor# 00350364 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER PUBLIC SAFETY MEDICAL SERVICES IN SUM OF$ CITY OF CARMEL 324 E NEW YORK ST SUITE 300 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. INDIANAPOLIS, IN 46204 Payee 7�3us .33 Purchase Order# ON ACCOUNT OF APPROPRIATION FOR Carmel Police 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 43-407.01 1 1 hereby certify that the attached invoice(s),or 3/7/18 officer physicals 1110 101 1110 101 43-407.01 bill(s)is(are)true and correct and that the 3/13/18 1110 101 materials or services itemized thereon for 1110 1 101 100944 00-32502 43-407.01 $7,385.33 3/14/18 I 00-32502 I officer physicals I $7,385.33 1110 101 which charge is made were ordered and 1110 101 received except Wednesday, March 14,2018 Jim Barlow Chief 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 Public Safety Medical - INVOICE o. Public Safety Medical Invoice Date: 03/13/2018 324 E.New York Street Invoice# 002502 Suite 300 Terms: `�•' Indianapolis,IN 46204 ' Cannel Police Department/CARMEPD 00 Pyoung@cannel.In.Gov (Yi) Exclusively Serving Public Safety Professionals Since.1990. :D"ate >.Erriployee`:".: :;:: DescTi on::. i4iriounf>;'. .Balaiice;�ue. I Exam $117.64 $117 Med Opinion-Wellness $0.00 $0.00 Med Opinion-Respirator $0.00 $0.00 Waistfl-lip Ratio $3.62 $3.62 Bodv Fat Test-BIA Bio Etec Im I 16.81 $16.81 Treadmill-Submax $183.59 $183.59 'Muscular Strength Endurance Test $21.21 $31,21 ReAbilit Test $12.01 U na sis-Dipstick $3.62 S3.621 EKG W1 Interp $24.01 $24.011 Audlometry $16.81 PFT-Pul onary FunrAlcm Test JA4.62 .6 V -Acuity $31.21 $31.21 Vital S' ns-HT WT BP P R $0.00 $0.00 Williams Ashlev L. Med inion-Wellness $0.00 $0.00 Med Opinion-Respirator $0.00 $0.00 Waist/HI Ratio $3.62 3.62 Bod Fat Test-BIA Bio-Elec Imp Ana 16.81 $16.81 Treadmill-Submax $183.50 $183.59 Muscular Stren th Endurance Test $31.21 $31.21 FleAbil' Test $12.01 $12.01 UrinalV&-Dipstick $3.62 $3.62 EKG W Inte $24.01 2 .0 Audlometry $16.81 $16.01 PFT-Pulmonary u ctio Test 62 Vision-Acuity 31.21 $31.21 Vital Signs-HT WT BP P R $0.00 $0.00 OnMed Program $0.00 $0.00 Respirator/Medical Review al9.21 $19.21 Health Risk is edikee 0:00 $0.00 Com rehensive Physical Exam $117-04 :<:.•_ _ •.fir•, 'r.:- .,t:,:. .Fa.-..t•. _.�_: 4... ..<: ':r •c:;:._,.- r q .i✓. iY -+•.;.. T•tai•:• •B (aiiae'Due''= ;z`. -:'�, iii9•'fs& a Public Safety .Medical - INVOICE a Public Safety Medical Invoice Date: 03/13/2018 !-• 324 E.New York Street Invoice# 002502 E�1 Suite 300 Terms: F. It' Indianapolis,IN 46204 Carmel Police Department!CARMEPD mPyoung@carmel.in.Gov (W) Exclusively Serving Public Safety Professionals Since 1990. Date:. Emplo" - °7 ':•: .,DesgiRtion: -knount Balanae.Due on -Collins,Shane i i WeflnesL_ S0.00 - Med Opinion-SWAT $0.00 $0. Med OPIn[on-Respirator $0.00 $0.001 WalsUHi Ratlo 62 3.62 Bodv Fat Test-BIA(Blo-Elec Imn Analy) $16.81 Treadmil $183,59 $183.6 Muscular Strength nce Test $31.21 $31.21 Flexibill Test 1 $12.01 na -DI tide 3.62 EKG W1 Inte 1 $24.01 Audiomeby $16.81 Irnonary FurwAon Test $44.62 $44.62 Vision.-AcLAW V ion- Vital Si ns-HT WT BP P R $0.00 $0.00 OnMed Program $0.DO $0.00 Res Irator/Medical Review $19.21 $19.21 Health Risk AnDralsal Medike .00 $0.00 Comprehensive Physical Exam 117.E $117.64 Jellison. n D OnMed Program $O.OG ResolratorIM-edical fteview 919.21 19.21 Health sk AopraisaUMedlkee Comprehenahte Physical 117.64 $117.64 Med O I -WeHness $0.00 Mad inion-S 0 Me -Respirator 10.00 $0.00 Waist/Hl Ratio $3.62 .82 Body Fat Test-BIA Bio-Eleo Imp Anal 16.81 $16.811 Treadmill-Submax $183.59 $183.5 Udna is-Di stick 3.62 $3.6 EKG W1 Interp $24.01 $24.01 u om $16.81 $16.81 PFT-Pulmonaly Functl est .6 .6 Vlslon-Acuity 1. $31.21 Vital Siansz HT WT B 0• Loveall.Gregory .O inion-Wellngs 00 0.00 ed -SWAT 0 Respirator .00 Public Safety Medical - INVOICE :.o., Public Safety Medical Invoice Date: 03/13/2018 •• r 324 E.New York Street Invoice# 00-32502 ' i Suite 300 Terms: Indianapolis,IN 46204 Carmel Police Department 1 CARMEPD m ` Pyoung@carmel.In.Gov (VI) Exclusively Serving Public Safety Professionals Since 9990. 17ate' ;Em'lo qe. ' .. Dption':a,.',• Amount", .Beland6..Du:esv Ratio .62 Body Fat Test-BIA Blo-Eleo Imp Anel $16.81 $16.81 .Treadmill-Submax $183.59 183.5 FleXibil Test $12.01 $12.01 dna is-Di Ick .62 .62 EKG W1 Int 4.01 $24.01 Audlometry $16.81 $1§,81 PFT-Pulmonaiv Unction Test $".62 $44.62 Vision-Acuity 1.21 $31.21 Vbl Signs-HT WT BP P R 10.00 OnMed Proaram S0.00 $0.(30 Resoirator/Modicalew $12.21 Health Risk AnDraisal(M dikewer) Comprehensive Physical Exam $117.64 $117. Miller Michael G. OnMed Program $0.00 0. Respirator/Medical Review 19.21 18.21 Health Risk raisal(Medlkeeperl $0.00 $0.00 CQ m rehensive Physical Exam717. 117.64 Med Opinion-Wellness $0.00 $0.00 Med Opinion-ReSpIrator SOLO $0.0 Ratio $3.62 .62 Bod Fa -SIA(Bio- e 1 Treadmill-Submax $183.59 $183.69 MusgUlar Strencith Endurance.Test ReAbIlb Test 112,01 $12.0 Udna als-Dipstick $3.62 $3.62 EKG W/Interp $24.01 $24.01 Audiametry $16.81 $16.81 PFT-Pulmonary Function Tet $44.52 $44.6 Vision-Actilty $31.21 1.21 Vital Signs-HT WT BP P R $0.00 000 Ri Janathan D. Med Opinion-Wellness $0.00 $0.00 Mad Opinion-Respirator .00 $0.00 Weis in Ratio 62 M62 Body Fat Test-BIA(Blo-Eleo Imp a 6.81 $16.81 Tmadmil -Subutax $103.6 18 Endurance Test S31.21 I Public Safety Medical - INVOICE o:: Public Safety Medical Invoice Date: 0311312018 s 324 E.New York StreetInvoice# 00.32502 i Suite 300 Terms: .�. : Indianapolis,IN 46204 Cannel Police Department!CARMEPD Pyoung@carmel.in.Gov (W) Exclusively Serving Public Safety Professionals Since 1990. Date:.:: 4 mployee :Desai 4on°: Amount Balance Due :Flexiblill .Test:.> S12.01 $12. Urinalysis-Dipstick .62 $3.62 EKG W/Interp 24.01 $24.01 Audlomew 16.81 $16.811 PFT-Pulmonary Function Test $44.62 $44.621 Usio Acuity-- 31.21 $31.211 Vital Sf n -HT WT BP P R $0.00 .0 QnMed Pro ram $0.00 $0.00 Res dical Re ' 19 Health Risk isal(Medikeeperl 0•00 Comvrehensive Physical Exam $117.641 $117.64 White 11,Robe -Wellness 0 Med Opinion- .00 $0.00 Waist/Hi Ratio $3.62 $3.62 Body Fat Test-BIA Bio-Elec Im Anal 16.61 $16.81 Treadmill-Submax 183 59 $J83.59 Muscular Strength Endurance Test 931.21 $31.21 ReAl ilTest $12.01 12.01 Urinalysis-Dipstick .62 $3..62 EKG W/Interp $24.0 $24.011 Audiometry $16.81 $16.81 PFT-P lmonary Function Test $44.62 N sion Aculty $31.21 $31,21. - Vital i ns-HT WT 0.00 .00 00Mftd Program 90.00 1 90.00 Respirator/Medical Review $19.21 $19.21 Health Risk Appraisal Medike er) $D.0 Com rehensive Ph cal Exam $117.64 $117.64 Wiggiman,Chad R. OnMe .P ram $0.00 $0.001 RosalratorlMedcal Review $19.21 19.21 Health Risk ftmlsal Msdlkee er 0.00 $0.00 Comvrehensive Physical Exam $117.84 $117, Med Opinnon-Wellness $0.00 $0.0 Mad Opinion-RespIrator $0.00 Wais f 2 Body F t est-BI Anal $16.81 6.81 Treadmill- bmax ti pm-sm S183.52 Public Safety Medical w INVOICE ., g:: Public Safety Medical Invoice Date: 03/13/2018 324 E-New York Street Invoice# 00-32502 Suite 300 Terms: Indianapolis,IN 46204 o' Carmel Police Department/CARMEPD Pyoung@carrnel.In.Gov (UI) Exclusively Serving Public Safety Professionals Since 1990. tate' • .::: ,:':.:. Errj lo'ee:': =:Dekriptton•: ;.Amount: Qalance.Due Fle 'bi 12.01 Urine is-DPW& $3.62 $3.62 EKG W/Interp $24.01 $24.01 Audiomeby 16.8116.81 PFT-Pulmonary Function Test $44.62 Vision-A 1.21 $31.21 Vital Signs-HT WT BPP .00 $0.00 Rawat CBCCom Blood Count .00 $0.00 Ven -NIM $0.00 $0.00 03/08118 Bay.-ChriltopherA. OnMed Proaram $0.00 Respira I Review $19.21 $19.21 Health Rilk Appraisal Wedkemepod $0.00 $04 ,. .Comgrehensive Physical Eam $117.64 S117.64 Med Opinion-Wellness $0.00 $0.00 Med Opinion-Respirator $0.00 $0.0 Walst/Hi Ratio $3.62 $3.62 Bodv Fat Test-BIA Bio-Ele f 16.81 $16.81 Treadmill-Submax $183.59 $183.59 Muscular Strancdh Endurance Test $31.21 S31.21 Flexiblifty Test 1 $12.01 3.62 Sa EKG W1 Interp $24.01 $24,01 AudomeMi 16.81 $16.81 PFIF-Pulmonary Function Test S44.62 2 Vision-Acuity Vital Si ns-HT WT BP P R $0.00 $0.00 HaW,Zachery R. OnMed Progiram $0.00 $0.0 Respirator/Medical Review $19.21 $19.21 Health Risk Appraisal(Medlikeeparl $0.00 $0.00 Comprehensive Physical Exam $117.64 $117.64 Mod OpInlon-Wellness 00 $0.00 Med Opinion-Respirator $0.00 $0.00 Waist/HipWaist/Hip R do $3.62 $3.1321 Body Fat Test--81A is. $16.81 Treadmill'-Submax 183.59 Muscular S_trenath Endufance Test $31.21 $31.21 FI xib 1 Test Public Safety Medical - INVOICE Public Safety Medical Invoice Date: 03/13/2018 324 E.New York Street Invoice# 00-32502 Suite 300 Terms: i Indianapolis,IN 46204 Carmel Police Department I CARMEPD Pyoung@carmel.in.Gov (Vi) Exclusively Serving Public Safety Professionals Since 9990. Date: :Employee`. :;:' - Desca"tion .'t:,. A'rrrount: Balance Due -DIDMck $3.62 $3,L2 EKG W/In $24.01 $24.01 Audlometry $16.81 $16.81 PFT-PulmonaEy Function Test $44.62 $44.6 Vision-Acuity 21 $31.21 Vital Signs-HT WT BP P R $0.00 $0.00 Hill Nathaniel W. Med Opinion-Welinpes $0.00 Med Opinion-Respirator $0.00 $0.00 Waist/HipWaist/Hip Ratio 3.62 Body Fat Tes - Anal 16.81 Treadmill-Submax 9183.59 $183.69 Urinalysis-Dipstick $3.62 EKG W/Intero 4.01 Audlometry $16.81 $16.81 PFT-Pulmonary Function Test .62 Vision-Acuity31.21 31.21 Vital 5 n -HT WT BP P R 0.00 0.00 OnMed Program .0 0.00 Respirator/Medical Review 9.21 $19.21 Health Risk Appraisal(Medikeeparl $0.00 om rehe sive Ph lcal Exam $117.64 $117.64 Xlnahom.Kevind Pro ra $0.00 Res irator aReview 19.21 919.21 Health Risk Appralsol(Madikepoff) $0,00 $0.0 QgMarghensive 1 Med Opinion-Wellness $0.00 $0.00 Med Ovinion-Res irator 0.00 $0.00 Waist/Hi Ratio $3.62 $3.62 Body Fat Test-BIA Bio-Elec Imp Anel 16.81 $16.81 Treadmill-Submax $183.59 $183.59 Muscular Strength Endurance Test $31.21 $31.gl Fle)(ibility,Test $12.01 $12.01 Urinalysis-Di stick $3.62 3. 2 EKG W/Intern 24.0 24.01 Audiometry 16.8 6.81 PFT-Eulmonery Function Test 2 $44.6 Public Safety Medical - INVOICE I Public Safety Medical Invoice Date: 03113/2018 324 E.New York Street Invoice# 00-32502 :. Suite 300 Terms: 1. 10 ai Indianapolis,IN 46204 Carmel Police Department/CARMEPD Lam: rom Pyoung@carmel.In.Gov (W) Exclusively Serving Public Safety Professionals Since 1990. oyee, :: ,.;.Desai tioh.' :; . Amoun '''' BalancevD e P R $0.00 $0.00 Sedberry.Jeffrey T. Med Opinion-Wellness $0.00 $0.00 Med Opinion-Respirator $0.00 $9.00 Waist/Hi Ratio $3.62 $3.62 Body Fat Test-BIA Bio-Elec Imp Anal16.81 $16.81 Treadmill-Submax $183.59 $183.59 solar Stren0i Endurance Test $31.21 $31.21 FleAtillity_Tftst $12.01 $12.01 Urinalysis-Di Uck $3.62 EKG W/Intera $24.01 $24.01 AudigMgtry $16.81 PFT-Pulmonary Function Test gg.62 6 -Vision-Acuity $Z1.21 $3,1.21- Vital Signs-HT WT BP P R $0.00 $0.0 OnMed Program 50.00 $0.00 Respirator/Medical Review $19.21 $19.21 Health RI Appraisal Medike er 0.00 $0.00 Comprehensive Physical Exam $117.64 $117.84 Theis Adam G. OnMed Pro ram $0.0o $0.00 Respirator/Medical eview $19.21 $19.211 Health Risk Appraisal(Medikeeperl S0100 .00 AM13rahensive Physical Exam $117.64 $117.64. Med Oolnlon-Wellness .00 $0.00 M O i to -Res 'ret r Waist/HiWaist/Hin Ratio 93.62 $3.62 Body Fat Test-BIA Bio-Elec Imp Anal $16.81 $16.81 Treadmill-Submax $183.59 $183.59 Flexibility Test $12.01 $12.01 Urinal is-Dipstick $3.62 $3.62 EKG W1 Interp $24.01 $24.01 Audlometry $16.8116.81 0 62 $44.62 Vision-Acuity 31.21 $0.00 Trover..Darin M. OnMed Program $0.00 $0.00 Resniratorilyledical Rewlew1 $12,211 Health Risk AnDmisal Med kee er 0 00