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Home My WebLink About325968 06/05/18 (9, CITY OF CARMEL, INDIANA VENDOR: 367222 ONE CIVIC SQUARE IU HEALTH WORKPLACE SERVICES LLCCHECK AMOUNT: S****61,050.91 CARMEL, INDIANA 46032 2046 RELIABLE PKWY CHECK NUMBER: 325968 CHICAGO IL 60686-0020 CHECK DATE: 06/05/18 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 301 5023990 763239 45,562.80 OTHER EXPENSES 601 5023990 763242 90.00 OTHER EXPENSES 301 5023990 763243 13,183.91 OTHER EXPENSES 301 5023990 763310 1,262.80 301 5023990 763496 951.40 OTHER EXPENSES VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) Vendor#".3 VTY2z ALLOWED 20 ACCOUNTS PAYABLE VOUCHER U 1 -rY_ Tl,+ "=pfd'StkVIC°83INSUM 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 $61,050.91 ON ACCOUNT OF APPROPRIATION FOR Purchase Order# 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 763239 50-239.90 $45,562.80 1 hereby certify that the attached invoice(s),or 5/31/18 763239 May Onsite Staff Time $45,562.80 301 301 301 301 763242 50-239.90 $90.00 bill(s)is(are)true and correct and that the 5/31/18 763242 May Onsite Wellness UDS $90.00 301 1 1 301 materials or services itemized thereon for 301 1 301 763496 50-239.90 $951.40 5/31/18 763496 May Onsite billing $951.40 301 301 which charge is made were ordered and 301 301 763310 50-239.90 $1,262.80 received except 5/31/18 763310 May Onsite PEPM $1,262.80 301 301 301 301 763243 50-239.90 $13,183.91 5/31/18 763243 May Misc Onsite $13,183.91 301 301 301 301 Monday,June 4,2018 Barbara Lamb 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 May 31, 2018 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Staff Time/May 2018 1 Civic Square . Carmel,IN 46032- Invoice# 763239 Service Date Description Quanti Charge Receipt Ad'us Balance 05/01/2018 R.N.Staff Time 5.00 319.30 319.30 Geraldine MacKenzie 05/01/2018 M.A.Staff Time 8.60 248.02 248.02 Amber Helton 05/01/2018 R.N.Staff Time 5.75 367.20 367.20 Stacey Neese 05/01/2018 N.P.Staff Time 5.50 638.33 638.33 Tina Nitsos 05/01/2018 MD Staff Time 5.00 901.25 901.25 Dr.Fagan 05/02/2018 M.A.Staff Time 4.40 126.90 126.90 Ashley Ellis 05/02/2018 R.N.Staff Time 9.75 622.64 622.64 Stacey Neese 05/02/2018 N.P.Staff Time 9.00 1,044.54 1044.54 Tina Nitsos 05/03/2018 M.A.Staff Time 4.70 135.55 135.55 Kimberly Pride 05/03/2018 R.N.Staff Time 4.50 287.37 287.37 Stacey Neese 05/03/2018 MD Staff Time 4.00 721.00 721.00 Dr.Fagan 05/04/2018 M.A.Staff Time 5.30 152.85 152.85 Kimberly Pride 05/04/2018 R.N.Staff Time 7.25 462.99 462.99 Stacey Neese 05/04/2018 Health Coach Staff Time 5.00 329.60 329.60 Kristin Hullett 05/04/2018 N.P.Staff Time 5.50 638.33 638.33 Tina Nitsos 05/04/2018 MD Staff Time 5.00 901.25 901.25 Dr.Fagan Submifted To JUN 0 5 2018 Clerk Treasurer Invoice# 763239(continued)page 2 Service Date Description Quant! Charge Recei Adjust Balance 05/07/2018 MD Staff Time 5.00 901.25 901.25 Dr.Fagan 05/07/2018 M.A.Staff Time 8.23 237.35 237.35 Kimberly Pride 05/07/2018 R.N.Staff Time 9.50 606.67 606.67 Stacey Neese 05/07/2018 Health Coach Staff Time 7.00 461.44 461.44 Kristin Hullett 05/07/2018 N.P.Staff Time 4.50 522.27 522.27 Tina Nitsos 05/08/2018 MD Staff Time 5.00 901.25 901.25 Dr.Fagan 05/08/2018 M.A.Staff Time 8.17 235.62 235.62 Kimberly Pride 05/08/2018 R.N.Staff Time 9.50 606.67 606.67 Stacey Neese 05/08/2018 N.P.Staff Time 5.50 638.33 638.33 Tina Nitsos 05/09/2018 M.A.Staff Time 9.10 262.44 262.44 Kimberly Pride 05/09/2018 R.N.Staff Time 10.00 638.60 638.60 Stacey Neese 05/09/2018 N.P.Staff Time 9.00 1,044.54 1044.54 Tina Nitsos 05/10/2018 MD Staff Time 4.00 721.00 721.00 Dr.Fagan 05/10/2018 M.A.Staff Time 4.50 129.78 129.78 Kimberly Pride 05/10/2018 R.N.Staff Time 4.50 287.37 287.37 Stacey Neese 05/11/2018 MD Staff Time 5.00 901.25 901.25 Dr.Fagan 05/11/2018 M.A.Staff Time 5.80 167.27 167.27 Kimberly Pride 05/11/2018 M.A.Staff Time 5.30 152.85 152.85 Amber Helton 05/11/2018 R.N.Staff Time 6.00 383.16 383.16 Stacey Neese 05/11/2018 Health Coach Staff Time 5.00 329.60 329.60 Kristin Hullett 05/11/2018 N.P.Staff Time 6.00 696.36 696.36 Tina Nitsos 05/14/2018 R.N.Staff Time 8.00 510.88 510.88 Von McClain 05/14/2018 Health Coach Staff Time 7.00 461.44 461.44 Kristin Hullett 05/14/2018 N.P.Staff Time 4.50 522.27 522.27 Tina Nitsos Invoice# 763239(continued)page 3 Service Date DescriptionQuant! Charae Receip A 'us Balance 05/14/2018 M.A.Staff Time 9.50 273.98 273.98 Kimberly Pride 05/14/2018 MD Staff Time 5.00 901.25 901.25 Dr.Fagan 05/15/2018 R.N.Staff Time 9.75 622.64 622.64 Stacey Neese 05/15/2018 N.P.Staff Time 5.50 638.33 638.33 Tina Nitsos 05/15/2018 M.A.Staff Time 8.33 240.24 240.24 Kimberly Pride 05/15/2018 MD Staff Time 5.00 901.25 901.25 Dr.Fagan 05/16/2018 R.N.Staff Time 9.75 622.64 622.64 Stacey Neese 05/16/2018 N.P.Staff Time 9.00 1,044.54 1044.54 Tina Nitsos 05/16/2018 M.A.Staff Time 8.20 236.49 236.49 Kimberly Pride 05/17/2018 R.N.Staff Time 4.75 303.34 303.34 Stacey Neese 05/17/2018 M.A.Staff Time 4.50 129.78 129.78 Kimberly Pride 05/17/2018 MD Staff Time 4.00 721.00 721.00 Dr.Fagan 05/18/2018 M.A.Staff Time 3.40 98.06 98.06 Maria Collins 05/18/2018 R.N.Staff Time 6.00 383.16 383.16 Stacey Neese 05/18/2018 Health Coach Staff Time 5.00 329.60 329.60 Kristin Hullett 05/18/2018 N.P.Staff Time 5.50 638.33 638.33 Tina Nitsos 05/18/2018 M.A.Staff Time 5.20 149.97 149.97 Kimberly Pride 05/18/2018 MD Staff Time 5.00 901.25 901.25 Dr.Fagan 05/21/2018 MD Staff Time 5.00 901.25 901.25 Dr.Fagan 05/21/2018 R.N.Staff Time 10.00 638.60 638.60 Stacey Neese 05/21/20.18 Health Coach Staff Time 7.00 461.44 461.44 Kristin Hullett 05/21/2018 N.P.Staff Time 4.50 522.27 522.27 Tina Nitsos 05/21/2018 M.A.Staff Time 8.20 236.49 236.49 Kimberly Pride 05/22/2018 MD Staff Time 5.00 901.25 901.25 Dr.Fagan Invoice# 763239(continued)page 4 Service Date Description Quanti Char a Receipt Adiust Balance 05/22/2018 R.N.Staff Time 9.75 622.64 622.64 Stacey Neese 05/22/2018 N.P.Staff Time 5.50 638.33 638.33 Tina Nitsos 05/22/2018 M.A.Staff Time 8.52 245.72 245.72 Kimberly Pride 05/23/2018 R.N.Staff Time 10.00 638.60 638.60 Stacey Neese 05/23/2018 N.P.Staff Time 8.75 1,015.53 1015.53 Tina Nitsos 05/23/2018 M.A.Staff Time 8.03 231.59 231.59 Kimberly Pride 05/24/2018 MD Staff Time 4.00 721.00 721.00 Dr.Fagan 05/24/2018 M.A.Staff Time 4.50 129.78 129.78 Kimberly Pride 05/24/2018 R.N.Staff Time 6.00 383.16 383.16 Stacey Neese 05/25/2018 MD Staff Time 5.00 901.25 901.25 Dr.Fagan 05/25/2018 M.A.Staff Time 4.90 141.32 141.32 Kimberly Pride 05/25/2018 M.A.Staff Time 5.40 155.74 155.74 Amber Helton 05/25/2018 R.N.Staff Time 6.00 383.16 383.16 Stacey Neese 05/25/2018 Health Coach Staff Time 5.00 329.60 329.60 Kristin Hullett 05/25/2018 N.P.Staff Time 5.50 638.33 638.33 Tina Nitsos 05/29/2018 M.A.Staff Time 6.70 193.23 193.23 Kimberly Pride 05/29/2018 MD Staff Time 5.00 901.25 901.25 Dr.Fagan 05/29/2018 R.N.Staff Time 9.75 622.64 622.64 Stacey Neese 05/29/2018 N.P.Staff Time 5.50 638.33 638.33 Tina Nitsos 05/30/2018 M.A.Staff Time 8.47 244.27 244.27 Kimberly Pride 05/30/2018 R.N.Staff Time 9.75 622.64 622.64 Stacey Neese 05/30/2018 N.P.Staff Time 9.00 1,044.54 1044.54 Tina Nitsos 05/31/2018 M.A.Staff Time 4.50 129.78 129.78 Kimberly Pride 05/31/2018 MD Staff Time 4.00 721.00 721.00 Dr.Fagan Invoice# 763239(continued)page 5 Service Date Description Quant! Charge Receip Aam-st Balance 05/31/2018 R.N.Staff Time 4.00 255.44 255.44 Geraldine MacKenzie CITYCARO Invoice# 763239 Balance Due: 45562.80 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK Indiana University,Health Workplace Services,LLC 714 N.Senate Avenue Suite 200 Indianapolis, IN 46202 317-963-1535 Tax ID# 20-0994452 Invoice May 31, 2018 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Wellness UDS/May 2018 1 Civic Square Carmel,IN 46032- Invoice# 763242 Service Date DescriptionQuant! Charge Recei AdLu-sl Balance 05/04/2018 Quick Read UDS/6panel includes 1.00 15.00 15.00 kit 15.00 SSOPH1Lted T o JUN 0� 2018 filerk Treasu.. Invoice# 763242(continued)page 2 Service Date Description Quanti Charge Recelp Ad'us Balance CITYCARO Invoice# 763242 Balance Due: 90.00 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK Indiana University Health Workplace Services,LLC 714 N.Senate Avenue Suite 200 Indianapolis, IN 46202 317-963-1535 Tax I D# 20-0994452 Invoice May 31, 2018 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite On-Site Billing/May 2018 1 Civic Square Carmel,IN 46032- Invoice# 763496 Service Date Description anti Charge Recelp AW-u—stBalance 05/01/2018 Onsite Facility Operations 1.00 102.80 102.80 05/01/2018 Onsite Operating Supplies 1.00 848.60 848.60 CITYCARO Invoice# 763496 Balance Due: 951.40 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK E To18 Indiana University Health Workplace Services,LLC 714 N.Senate Avenue Suite 200 Indianapolis, IN 46202 317-963-1535 Tax I D# 20-0994452 Invoice May 31, 2018 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite PEPM/May 2018 1 Civic Square Carmel,IN 46032- Invoice# 763310 Service Date Description Quanti Charae Recei AW—us-1 Balance 05/01/2018 Monthly Wellness PEPM 616.00 1,262.80 1262.80 CITYCARO Invoice# 763310 Balance Due: 1262.80 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK E5SUbmitted Indiana University Health Workplace Services, LLC 714 N.Senate Avenue Suite 200 Indianapolis, IN 46202 317-963-1535 Tax ID# 20-0994452 Invoice May 31, 2018 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Misc.Onsite/May 2018 1 Civic Square Carmel,IN 46032- Invoice# 763243 Service Date Description Quanti Charge Recei Ad'us Balance 04/01/2018 Onsite Lab Charges 1.00 3,496.28 3496.28 April 2018 Labs 04/01/2018 Utility Expenses 1.00 -335.83 -335.83 Credit from April 2018 Utility Charges 04/27/2018 AS Medical Solutions Clinic Meds 1.00 601.76 601.76 04/30/2018 AS Medical Solutions Clinic Meds 1.00 546.52 546.52 04/30/2018 Video Visit 3.00 147.00 147.00 05/01/2018 Utility Expenses 1.00 694.19 694.19 05/01/2018 Building Expenses 1.00 1,086.87 1086.87 05/01/2018 Lease Expense 1.00 4,316.05 4316.05 05/04/2018 AS Medical Solutions Clinic Meds 1.00 1,567.01 1567.01 05/07/2018 AS Medical Solutions Clinic Meds 1.00 27.47 27.47 05/10/2018 AS Medical Solutions Clinic Meds 1.00 35.35 35.35 05/15/2018 AS Medical Solutions Clinic Meds 1.00 944.84 944.84 05/18/2018 AS Medical Solutions Clinic Meds 1.00 56.40 56.40 CITYCARO Invoice# 763243 Balance Due: 13183.91 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK Submitted To JUN 05 2018 Clerk Treasurer