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HomeMy WebLinkAbout325026 05/09/18 CITY OF CARMEL, INDIANA VENDOR: 367222 i; ONE CIVIC SQUARE IU HEALTH WORKPLACE SERVICES LLCCHECK AMOUNT: $.....1,277.35* CARMEL, INDIANA 46032 2046 RELIABLE PKWY CHECK NUMBER: 325026 9M_roN.Lo` CHICAGO IC 60686-0020 CHECK DATE: 05/09/18 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBERAMOUNT DESCRIPTION 1201 4358800 762843 345.00 TESTING FEES 1205 4347500 762955 932.35 GENERAL INSURANCE VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) Vendor# 367222 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER IU HEALTH WORKPLACE SERVICES LLC IN SUM OF$ 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 $345.00 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 762843 43-588.00 $345.00 1 hereby certify that the attached invoice(s),or 4/30/18 762843 Onsite Occupational UDS April $345.00 1201 101 1201 101 bill(s)is(are)true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except Thursday, May 3,2018 Lamb, Barbara Director I hereby certify that the attached invoice(s),or bill(s),is(are)true and correct and I have audited same in accordance with IC 5-11-10-1.6 120 Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer 1� Indiana University Health Workplace'Services,LLC 714 N.Senate Avenue Suite 200 Indianapolis, IN 46202 317-963-1535 Tax I D# 20-0994452' Invoice April 30, 2018 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Occupational UDS/Apr.2018 1 Civic Square Carmel,IN 46032- Invoice# 762843 Service Date Description Quanti Charge Recei Ad u-s Balance 04/09/2018 Quick Read UDS/6panel includes 1.00 15.00 15.00 kit 15.00 kit ; mss EM bn 4� ed To AY 02 2018 9 � Treasurer Invoice# 762843 (continued)page 2 Service Date Description 15.00 04/04/2018 Quick Read UDS/6panel includes 1.00 15.00 15.00 kit Shannon Minnaai XXX-XX-9240 Balance Due: 15.00 Invoice# 762843 (continued)page 3 Service Date Description Quanti Charge Receipt Ad'us Balance 04/17/2018 Quick Read UDS/6panel 15.00 CITYCARO Invoice# 762843 Balance Due: 345.00 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) Vendor# 367222 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER IU HEALTH WORKPLACE SERVICES LLC IN SUM OF$ CITY OF CARMEL 2046 RELIABLE PKWY An invoice or bill to be propedy 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 762955 43-475.00 $932.35 I hereby certify that the attached invoice(s),or 4/30/18 762955 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 Wednesday, May 2,2018 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 April 30, 2018 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite EAP Services/April 2018 1 Civic Square Carmel,IN 46032- Invoice# 762955 Service Date DescriptionQuant! Charge Receip Ad'us Balance 04/01/2018 EAP Services 643.00 932.35 932.35 CITYCARO Invoice# 762955 Balance Due: 932.35 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK S imi=ftee1 T MAY 0 2 2018 cher k