HomeMy WebLinkAbout326173 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