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Home My WebLink About326173 06/12/18 CITY OF CARMEL, INDIANA VENDOR: 00350364 a. ONE CIVIC SQUARE PUBLIC SAFETY MEDICAL SERVICES CHECK AMOUNT: $*****2,107.51 4. � CARMEL, INDIANA 46032 6612 E.75TH STREET CHECK NUMBER: 326173 F�„iTON. SUITE 200 CHECK DATE: 06/12/18 INDIANAPOLIS IN 46250 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1110 4340701 100944 0032862 1,471.12 OFFICER PHYSICALS 1110 4340701 100944 0032995 636.39 OFFICER PHYSICALS VOUCHER NO. WARRANT NO. Prescribed by state Board of Accounts City Form No.201(Rev.1995) Vendor# 00350364 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER PUBLIC SAFETY MEDICAL SERVICES IN SUM OF$ 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 $2,107.51 ON ACCOUNT OF APPROPRIATION FOR Purchase Order# 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 100944 00-32862 43-407.01 $1,471.12 1 hereby certify that the attached invoice(s),or 5/9/18 00-32862 officer physicals $1,471.12 1110 101 1110 101 100944 00-32995 43-407.01 $636.39 bill(s)is(are)true and correct and that the 5/31/18 00-32995 officer physicals $636.39 1110 1 1 101 materials or services itemized thereon for 1110 1 101 which charge is made were ordered and received except Friday,June 1,2018 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 distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer Public Safety Medical - INVOICE COME °°r Public Safety Medical Invoice Date: 05/3112018 ". 6612 E.75th Street � Invoice# 00-32995 Floor 2' Terms: Indianapolis,IN 46250 Carmel Police Department/CARMEPD Pyoung@carmel.In.Gov (W) Exclusively Serving Public Safety Professionals Since 9990. ;_.Da MComprehensive {'�� rite'3Yb_f�4e�. _. _..J_ -.;'ac :..'SL:�k'31 72i5'05121118 Schoeff Jr..Dgnald 0. Pro rn 0.00 .00 or/Medical Review $19.21 19.21 iskA isal Medikee er DO .00 ensive Ph foal Exam $117.64 $117.6 Med 0 inion-Wellness $0.00 $0.00 Med Opinion-Respirator $0.00 $0.00 Waist/Hi Ratio $3.62 $3.82 Body Fat Test-BIA Blo-Elec Im Anal 16:81 $16.81 e -5 Muscular tren Endurance Test $31.21 $31.21 Rexibill Test $12.01 $12.01 Qlaftell S72.027 0 Urinalysis-a tick 2 EKG W/Interp $24.01 $24.01 Audiornetry $16.81 $16.81 PFT-Pulmonary Function Test $44.62 $44. Vision-Am 31.21 31.21 Iridal Signs-HT WT BP P R $0.00 0.00 05124/18 eff Jr.,Donald D. Chest X-Ray- 60.01 . .01 . :> ... _. F z.. .. :. C�� - _....:'_'+(;"ii. 7.�;....r5_ ..b- c��.�r .. :..,...�..,: V>? ?• ",".�$RYo salgtd,� n�.....�d vX�' ,G1'•fii w r' °fi '"i9v fi" ':i>'<P•' -.ma.+h•.-_,�+d.' '•,: .•pyx:+....r...��... '.aXeK�: �r ra:.�S- e. �:--,.r 'S,.e''�.:C:.'?Y.Y_ :'�-lisr`.iFi!' 15 �3• �F1�Spt,`�ss"w``�"•t§i:�»,�>�'�'[��..>Ai:_�..a.T, F�s:_. � 5'1 .��3, ±!?C�� '� .t �x�r �V?`' �C� Please write invoice number on payment check. Our Federal Employer Identification number is 35-2079797. We greatly appreciate the opportunity to serve you. If you have any questions regarding this invoice, please contact Michelle McClure at 317-964-2364. Public Safety Medical - INVOICE 4 Public Safety Medical Invoice Date: 05/09/2018 � : 6672 E.75th Street Invoice# 00.32862 - Floor 2 Terms: ` .R Indianapolis,IN 46250 P Cannel Police Department/CARMEPD HER �1a Pyoung@cannel.In.Gov (W) Exclusively Serving Public Safety Professionals Since 1990. --af�� r��`�°�= C�F�EpY�" r�'.�''��' ,��e=• �> �a�;�� 3i`'' $al`�%i�e�Ysie` ^.b... ... .. ....... ••1 Y. it w.�. _ .. .�LT.YI..1'Lh, �t��d't15:'.1w{t1.:1 ll'lC..•.1?1XS.l�....1)ff7 Health Risk isal ed ee er Cormrehenslve Ph cal Exam $117.64 $117.64 Med Opinion-Wellness .QO $0.0 Med Opinion-WAT $o.Do $0.00 Med Ownion-Respirator $0.00 $0.00 Waist/Hi Ratio $3.62 $3.62 Bodv Fat Test-BIA Bio-Elec Imp Anal 16.81 $16.81 Treadmill-Submax $183.59 $183.59 2 Urinal is-Di do $3.62 $3.62 EKG W1 Intem $24.01 $24.01 Audometry. $16.81 PIFT Pulmonary Funefion Test &M.62 IM-6 Vision-AcLdty $31.21 $31.21 Vidal Si ns-HT WT BP P R 0.00 .00 `�.'L'. 'L9 t '""{f i9,}i I:.at•• nr 1.i+ ar°q: ..�.. .. �_ ..ki.?•:.�.`'T re �'JC��u_.]'� i:i.{,m cy�jr ,. , f:• v .# �;ter' 1 1' .M•3ii'19 �1't'� :a+'x'1,!{LM 11'.,�lt�"sldi�l !��ti8'.rYU.rS� G:iifi!,il' �:' �.ti. „F.� ��i�,+ll�vcz�3.i n' :M�I, a�ii`:.i+a `tv�^,��L-y''.'",�kl'.?I:i��•�Wf„�.�I"Y� , ` ��. h.� �a, -''i'+•c1�' i['ir�n ..._�t�c[,�nH[5rc: .�' .ail�_'>+.'Jft1'��•�I��.�1:..1�Y�J1,,1..»t _�s(*(�� vrn:i�i•`.�� +i�vrfif.....�b•�4�C,ic-� ,:}}}:�^K-ir,Lgeci_3x��:Q:r:J}��r�_a.;uni%lS��j;::�._:ilgs ! Ir;rf; .ai • - [ij��1.w._.j�.�j.T•_ rl-+.17.II��I�R[ll'T(�"IW� j�� L"Y--IJS:t�•7>�.a}e� �•��1`�i9!Y �7.�. y' ��Mt��E1:rR��1Yl •SII JM�PtiAY.11•��T'�IS�:1 ..' ^AJC�tt,t� Please write invoice number on payment check. Our Federal Employer identification number is 35-2079797. We greatly appreciate the-opportunity to serve you. If you have any questions regarding this invoice, please contact Michelle McClure at 317-964-2364, Public Safety Medical - INVOICE ; li MPublic Safety Medical Invoice Date: 05109/2018 6612 E.75th Street Invoice# 00-32862 Floor 2 Terms: Indianapolis,IN 46250 10--po Carmel Police Department/CARMEPD MCI! Pyoung@carmel.In.Gov (W) Exclusively Serving Public Safety Professionals Since 1990. .. .. ...:;era 1n..t3•'i" I' L aw•tY s;n ... ` €Q i.ygi rj3ylfM.FfL'$n+i"A 111nwuilJ�lF:ink 04130118 Sem6ster.James S. OnMed Prograrn0 $O.OD Res Irator/Medical Review $19.21 $19.21 Health Risk ralsal Medike 00 .00 Hemoccult $0.00 $0.00 Comprehensive Physical Exam $117.641 $117.64 Med Opinion-Wellness $0.00 $0.00 Med Opinion-Respirator $0.00 $0 Waistlft Ratio $3.62 $3.62 Bodv Fat Bio-Elec I 1 Treadmill-Submax $183.5 183.59 ReAllb Test $12.01 $12.01 Chest X-Ray-PA/LAT(Diaitall $72 $72, Urinalysis-DinsUck 93.62 EKG W/I&M $24.01 '$24.01. Audlornetry $16.81 $16.81 PFT-Pulmonary Function Test $44.62 IM.62 Vision-Acuity 1.2 $31.21 Vidal Si -HT WT BP P R $0.00 $0.00 05/61/18 BiScott W. OnMed Pro ra 0.00 $0.00 Resolrator/Medical Review $19.21 $19.211 Health Risk A dikes er $0.00 so.00l CornDrehensive Physical Meda $0.001 $0.00 Mad fin-Real 12,62L $3.62 Bodv Fat Test-BIA Bio-Flet Imp Anal $16.81 16.81 Muscular Strength Endurance Test M$72.02 1.21 Fiexibill Test 12.01 Chest X-Ray-PA/LAT(Digital) 72.0Urinal sis-Di do 3.62EKG W/Inte $24.011 u 16.81 $16.81 P -Pulmonary Function Test $44.82 Vision-Acully $31.21 S31.21 Vital Signs-HT Vff SP P R so.00 3 8 Van .00 $g.00