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Home My WebLink About323998 04/10/18 ",cnq. �� ''' CITY OF CARMEL, INDIANA VENDOR: 367222 d °l ONE CIVIC SQUARE IU HEALTH WORKPLACE SERVICES LLCCHECK AMOUNT: 5"*** 2,016.35* ,a CARMEL, INDIANA 46032 2046 RELIABLE PKWY CHECK NUMBER: 323998 ,!-, `o, CHICAGO IL 60686-0020 CHECK DATE: 04/10/18 DEPARTMENT_ ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1201 4358800 762373 1,084.00 TESTING FEES 1205 4347500 762442 932.35 GENERAL INSURANCE I "r. VOUCHER NO. WARRANT NO. Prescribed by state Board of Accounts City Form No.201(Rev.1995) Vendor# 367222 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER ILI 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 $1,084.00 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 762373 43-588.00 $1,084.00 1 hereby certify that the attached invoice(s),or 3/31/18 762373 March 2018 Occupational UDS $1,084.00 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,April 9,2018 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 714 N.Senate Avenue Suite 200 Indianapolis, IN 46202 317-963-1535 Tax ID# 20-0994452 Invoice March 31, 2018 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Occupational UDS/Mar.2018 1 Civic Square Carmel,IN 46032- Invoice# 762373 Service Date Description Quanti Charge Recei Ad"Us Balance 03/14/2018 Quick Read UDS/6panel 15.00 kit - Invoice# 762373 (continued)page 2 Service Date Description 15.00 Invoice# 762373 (continued)page 3 Service Date Description 15.00 03/05/2018 Quick Read UDS/6panel includes 1.00 15.00 15.00 kit 03/05/2018 Confirmation for Quick Read Drug 1.00 15.00 15.00 Screen Jimmie W Kitterman XXX-XX-3108 Balance Due: 30.00 Invoice# 762373 (continued)page 4 Service Date Description 15.00 ----- - - - 03/09/2018 Quick Read UDS/6panel includes 1.00 15.00 15.00 kit Invoice# 762373 (continued)page 5 Service Date DescriptionQuant! Charge 15.00 03/12/2018 Quick Read UDS/6panel includes 15.00 r Invoice# 762373 (continued)page 6 Service Date Description 15.00 Invoice# 762373 (continued)page 7 Service Date Description Quantity Charcie Recei Aau-s Balance 03/14/2018 Quick Read UDS/6panel 15.00 Invoice# 762373 (continued)page 8 Service Date DescriptionQuant! Charge Receipt Afts Balance CITYCARO Invoice# 762373 Balance Due: 1084.00 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK APR 0 2018 gI1Pxd a ^'t 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 $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 762442 43-475.00 $932.35 1 hereby certify that the attached invoice(s),or 3/31/18 762442 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 Tuesday,April 10,2018 Crider,James Administration 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 714 N.Senate Avenue Suite 200 Indianapolis, IN 46202 317-963-1535 Tax ID# 20-0994452 Invoice March 31, 2018 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite EAP Services/March 2018 1 Civic Square Carmel,IN 46032- Invoice# 762442 Service Date Description Quanti Charae Recei AdLs Balance 03/01/2018 EAP Services 643.00 932.35 932.35 CITYCARO Invoice# 762442 Balance Due: 932.35 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK To APR 10 2018 Co. S L, ^'4C