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Home My WebLink About326830 06/29/18 CITY OF CARMEL, INDIANA VENDOR: 00350364 s ONE CIVIC SQUARE PUBLIC SAFETY MEDICAL SERVICES CHECK AMOUNT: $....10,989.84* CARMEL, INDIANA 46032 6612 E.75TH STREET CHECK NUMBER: 326830 M�Ftix�O, SUITE 200 CHECK DATE: 06/29/18 INDIANAPOLIS IN 46250 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1110 4340701 100944 0033105 10,989.84 OFFICER PHYSICALS VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) Vendor# 00350364 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER PUBLIC SAFETY MEDICAL SERVICES IN SUM OF$ CITY OF CARMEL 324 E NEW YORK ST SUITE 300 An invoice or bill to be property 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 $10,989.84 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 00-33105 43-407.01 $10,989.84 1 hereby certify that the attached invoice(s),or 6/20/18 00-33105 officer physicals $10,989.84 1110 101 1110 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,June 21,2018 un� &'.' 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 ; Public Safety Medical Invoice Date: 06120/2018 6612 E.75th Street Invoice# 00-33105 Floor 2 Terms: Indianapolis,IN 46250 Carmel Police Department/CARMEPD ° Py oung@carmel.In.Gov (W) Exclusively Serving Public Safety Professionals Since 1990. 0101 ally 9 ResplratorlMecrical Review $19.21 Health Risk A sal Medlk er $0.00 $0.00 Com rehensive Physical Exam $117.64 $117.64 Med Opinion-Wellness $0.00 $0.00 Med O into -Respirator $0.00 $0.00 Waist/Hi Rati 3.62 $3.62 Bodv Fat Test-BI Bio-Elec Imp AnslyY $16.81 $16.81 Treadmill-Submax $183,5 •59 la Styeth Endurance To 1.21 31 Flexib ' st 12 2.01 CPALL-AT(12in UrinalysiS-Dipstick $3.62 3.62 EKG W/Inte 24.01 24.01 Audiome 16.61 16.81 PFT-Pulmona Function Test .62 Vision-Acu 31.21 3 1 Vital SI ns-HT WT BP P R $0.00 $0.001 Diet&Aaron K. OnMed Program-, 0. $0.00 Bgspirator/Medigal Review $19.21 $19.21 Health Risk Angralsal(Mecrikeengr) 0.00 0 OO Comprehensive Physical E am $117, 7 Med Opinion-WeHness SO.Do $0.00 Med n_Resp' .00 $0.0 Wais t Body Fat Test-BIA Bio-Elec Imp Anal $16.81 $16.81 Treadmili-Submax $183.59 183.5 Muscular Strength Endurance Test 31.21 $31.21 Flexibl Test $12,01 2.01 Chest X-Ray-PA/LAT(Digital) 72. 2 72.0 Udnalysis-Dlr)sflck $3.62 $3.62 EKG torr) $24.01 1 Audlometry 916.81 .81 P -Pulmonary Function Test. .62 44. son-Aculbi $31.21 .2 Vital S WT BP P R $Q.00 0.00 Public Safety 'Medical - INVOICE .» �l Public Safety Medical Invoice Date: 06/20/2018 6612.E.75th Street Invoice# 00-33105 Floor 2 Terms: Indianapolis,IN 46250 Carmel Police Department I CARMEPD Ryoung@carmel.in.Gov (NI) Exclusively Serving Public Safety Professionals Since 1990. _ R _ M. Resnirator/Medical ReviewS1921 Health Risk Appraisal Medikee er $0.00 S0.001 Comprehensive Physical Exam $117.64 $117.64 Med O Inion-Wellness $0.00 $0.00 Med Opinion-Respirator $0.00 $0.0 WaistfHlp Ratio $3.62 3.62 Body Fat Test-BIA Bio-Elec m Anal $16,81 16 Treadmill-Submax $183.59 $183.59 Rb)dbilitv Test 912.01 $12.01 Chest X-Ray-PAILAT Di $72.02 Uri -Dinstick $3.62 W. EK 4.01 24 Au ' 116.811 PFT-Pulmonary Function Test $44.62 Vision-AGuh 1.21 $31.21 Vital Signs-HT WT BP P R $Q.00 .00 Hood Bryan L. OnMed Pro ram $0.00 $0.00 Respirator/Medical Review $19.21 $19.21 Health Risk Awralsal Medi er 0.00 $0.00 He cult .00 $0.00 comprehensive Physloal Exam $117.64 Me -Wellness' $0.00 $0.00 Med Opinion- or $0.00 $0.00 WalsAfft Ratio S3.62 S3.62 Body a Bio-EI 1 1 .81 Treadmill-Submax $183.59 $183.59 Flexibilltv Test $12.01 $12.01 Chest X-Ray-PAILAT DI ital 72:02 $72.0 Urinalysis-Di stick $3.62 $3.62 EKG W/Interp $24.01 $24.01 Audiornstry 916.81 alAm PFT-Pulmonmy Function t 44.6S".62. Vision-Multy $31.21 31.21 Vital Si SPP 0.0 Joseph H. OnMed ra 0 Rasolrator/Medical Review 19.21 Public Safety Medical - INVOICE �� Public Safety Medical Invoice Date: 06/20/2018 ; 6612 E.75th Street Invoice# 00-33105 Floor 2 Terms: Indianapolis,IN 46250 Carmel Police Department!CARMEPD .Pyoung@carmal.in-Gov A Exclusively Serving Public Safety Professionals Since 1990. • n ggmimehonkyo Phygol QLarn $117.64 1 17, Med Opinion-Wellness .00 M3.6 Med O inion-Res irator .00 Waist/Hi Ratio 3.62 - Bodv Fat Test-BIA Bio-Elec Imp Anal $16.81 $16.81 Treadmill-Submax 183.59 183.5 Muscular Strenath Endurance Test S31.21 $31.21 Elexibility Test $12.01 $12.01 Uri -Upstick 3.62 KG W 24.01 -Audiometry 6.81 16.8 P - lmonant E-unction Test $44.52 $44.62 ui 1.21 Vital SI ns-HT WT BP P R $0.00 T19..0201 06/14/16 Cra er William D. OnMed.Proram 0.00 Respirator/Medical Review $1921 H th Risk A ral I Medikee r 0.00 000 Com rehe sive Physical Exam $117.64 $117.64 Mad Opinion- ellness 0 .00 Med Opinion-Respirator $0.00 go.0a WaistIHi $3.62 .62 Body Fat Test-BIA 8I - e I 16.81 $16.01 Treadmill-Submax $183.59 $183.59 Muscular ndu e t Flexibility Test $12.01L $12.01 Chest X-Ray-PAIIAT(Digital) 72.02 $72.02 Urinalysis-Di stick $3.62 $3.62 EKG W1 Interp $24.01 $24.01 Audlornetry $16.81 $16.81 PFT-Pulmonary Function Test $44.62 $44.62 Vision- i 1.21a Vital Si ns'- BP P R .00 Fisher.Charles B. O Program0 i torNe ' eview 9 HealthI Appraisal r Corn sive P Exa 7.64 Public Safety Medical - INVOICE Public Safety Medical Invoice Date: 06120/2018 6612 E.75th Street Invoice# 00-33105 Floor 2 Terms: Indianapolis,IN 46250 Carmel Police Department/CARMEPD Pyoung@carmel.In.Gov (W) Exclusively Serving Public Safety Professionals Since 1990. Inion irato 00 Waist/Hi Ratio $3.62 $3.6 Body Fat Test-BIA Bio-Elec Imp Anal 16.81 $16.81 Treadmill-Submax 9183.59 $183.59 Muscular Strencith Endurance Test $31.21 $31.21 FlexiNilly Test, 12.01 $12.01 Urinalysis-Dlpstick $3.623.6 EKG WJto 4.01 $24.011 Audiometry. 6.81 $16.81, P -P Imonary Function .62 Vision-Acu' $31.21 $31.21 Vital ins- PP 0.00 min-g.Anna G. OnMed P 0.0 Respirator/Medical Review $19.21 $19.21 Health Risk Appraisal Medikee r .00 $0.00 Comprehensive Physical Exam $117.64 $117.6 Med O in n-Wellness $0.00. $0.0 Mad O inion-Respirator $0.00 $0.Q0 Waist/ Ratio $3.62 $3.62 Body Fat Test-B Bio-Elec Analy) $16.81 1 $16,81 Treadmill-Submax $183.59 $183.59 Musmiar Stre Endurance 31.2 ReAbili Tell $12.01 $12.01 -Ra -PAILXT(Qigftll $72,L2 $72.1) Urinalysis-D' tick $3,62 EKG W/Interp $24.01 $24.01 Audiometry $16.81 $16.81 PFT-Pulmona Function Test M831.21 $44.62 Vson-Am 1.2 Vi Si ns-HTWTBPPR 0.0 Hartin Chad V. O Pr ram Res ire edical Re . 0 0 19.21 Health Risk Appraisal Medike .00 0.0 He so.00 Comprehensive Physical Exam 117.64 $117.64. Medllness Public Safety Medical - INVOICE Public Safety Medical , Invoice Date: 06/2012018 6612 E.75th Street Invoice# 00-33105 Floor 2 Terms: t Indianapolis,IN 46250 Carmel Police Department/CARMEPD Pyoung@camrel.In.Gov (W) r Exclusively Serving Public Safety'Professionals Since 1990. � C¢ ----�� J3 a ,e i_ ...� �� '"'-'Q W'•;3t�'�''a: a n�u.,a�`•.a_�7�3�-�..��' �., Waist! do $3.62 3.6 Body Fat Test-BIA Bio-Elec Imp Anal 16.81 $16.81 Treadmill-Submax $183.59 183.59 Muscular Stnen Endurance Test 31.21 1.21 Flexi i, Test 12.01 12.01 Chest X-Ray-PAILAT(Digital) 72.02 72. 02 Urinal si -Dipstick 3.62 3.6 G W1 Inter 4.01 .01 Audiometry 916.R1 $16.81- PFT-Pu 16.PFT-Pu ona Funeflon Test .8 6 io -Agulty $31.21 $31.21 . vital Sin -HT WT 0 0.0 L tt M OnMed Pmgrarii- 0 Res IratorlMedical Review $19.21 $19.21 Health Risk Appraisal Medikee er 0.00 $0.00 Com rehensive Physical Exam $117.6 117.64 Med Opinion-Wellness $0.00 $0.00 Med Opinion-SWAT 90.00 Ag.00 Med O i ' -Rggpirator $0.00 $0.00 Wai i Ratlo $3.62 $3.62 Body Fat Test-BIA 10-Elec Imp Anal 81 $16.81 Treadmill-Submax 83.59 3183. lexibiri t 1 $12.0112.01 Chest X-Ray-PAUAT 2.0 UNnalyalp-Dinstick $3,62- $21.6 EKG W1 Interp $24.01 $24.01 Audlometry $16.81 PFT-Pulmonary Function Test $44.62 $44.62 Vision-Acuity 31.21 $31.21 Vital Si ns-HT WT BP P R $0.00 $0.00 Mallov.Kathed E. nMed Program 0.00 0.00 R i torNed' Review $19.21 19' Health Appraisal Medikee 0 00 Commehensive Physical $117.64 4 Med Opinion-Wallness $0,00 S0.001 Med O I ire 0 Public Safety Medical - INVOICE Public Safety Medical invoice Date: 0612012018 6612 E.75th Street Invoice# 00-33105 Floor 2 Terms: Indianapolis,IN 46250 Carmel Police Department/CARMEPD Pyoung@carmel.In.Gov (VI) Exclusively Serving Public Safety Professionals Since 19-90. O08KKK:.')f°i -e•''zY'•..• _ Body Fat T - I Bio- 1 Treadmill-Submax $183.59 183.59 Flexiblll Test 12.01 12.01 Udna sis-DI tido 3.62 $3.62 EKG WJ Interp 24.01 $24.04 Audiomet 16.81 16.81 PFT-Pulmonaryun on T •62 •6 Vision- i 31.2 31.21 tal glans ns- WT BP P 0.00 0• C -Ra -P (Didal 7 2go .02 OnMed m 0.00 00 Na to Jua 1921 RespiratorNgdIcal Rgylew Health Risk M r •0 Com rehensive Physical-Exam $117.64 $117.64 Med Opinion-Wellness 0.00 0.00 Med O Inion-Respirator $0.00 0.00 Wais i Ratio 3.62 3.62 Body Fat Test-BIA Bio-Elec Imp Anal $16.81 EE 16.81 Treadmill-Sub ax $183.59 $1 - Muscular Stren th Endurance Test $31.21 $31.211 Flex! i' est 2'01 Chest X-R -P Di 7 2. Urinalysis-Di .62 .6 1 EKG IN Inte $24.014.Audio met 81 $16. PFT-Pulmonary Function Test .62 44.62 Vision-Acuity $31.21 $31.211 Vital Si ns-HT WT BP P R 0.00 0.00 Med Opinion-Wellness 0.00 0.00 06115118 Gilmore.Jason M. 0.00 0.00 M Opinion-Res i for Respirator/Medical Re_vlew $19.219'21 Health 's A a1 Meftee 0.00 0' Co ensive Ph I Exam 4 117• wws i Rati 62 B Test-BIA •o-Elec Im 16. 6 1 Treadmill- 183 3.59 Public Safety Medical - INVOICE Public Safety Medical Invoice Date: 06/20/2018 y. :.► 6612 E.75th Street Invoice# 00.33105 Floor 2 1 Terms: Indianapolis,IN 46250 Carmel Police Department!CARMEPD Pyoung@carmel.In.Gov (111 Exclusively Serving Public Safety Professionals Since 1990. n 15.�.S . r . �,t.� y�„ IF3 i ¢ .t� 11 L v REG _ - RexibilltyTeg $12.01 , Urinalysis-Dipstick $3.62 $3.62 EKG W/Interp $24.01 $24.01 Audlometry $16.81 $16.81 PFT-Pulmonmy Function Test $44.62 $44.6 Vision-Acuity 1.21 $31.21 tai Sic ins-HT WT BP P R O.OD .00 OnMed Program $0.00 $0.00 Jent Danny N. OnMed ftgram 90.00 $O.DO Mod Opinion-Wellness $0.000 OpinionMad -Respirator 0.0 0.00 Res i w $19.21 $19.21 Health Risk Appraisal r 0.0 Comprehensive Physical Exam $117.64 $117.64 Waist/Hi Ratio $3.62 $3.62 Bodv Fat Test-BIA Bio-Elec Imp Anel 16.81 $16.81 Tre ill-Submax $183.59 183.59 Fle)dbilitvTest $12.01 $12-01 Chest X-Ray-PA/LAT Di ital 72.02 972. Urinalysis- .623.62 EKG W/Inte 4 0 24.01 AudlomeW 16.81 ul ary Function Test Vision-Antifty $31.21 $31.21 Vital n -HTWTBPPR 90.00 Kim Christopher J. OnMed Program $0.00 $0.00 Respirator/Medical Review $19.27 19.21 Health Risk Appraisal Medikee er $0.00 $0.00 Comprehensive Physical Exam $117.64 $117.6 Med Opinion-Wellness 0.00 $0.00 Med Opinion-Respirator $0.00 Waist/Hi Ratio .62 .Bodv Fats -B Bio-Elec Imp Analv) 8 16.81 Treadmill-Submax $183.59 $183, 9 uscular Strenath Endumnr.6 Test $31.211.21 ReAbIlity Test $12,0-1 12.01 Public Safety Medical - INVOICE �p M_S Public Safety Medical Invoice Date: 06/20/2018 6612 E.75th Street Invoice# 00-33105 Floor 2 Terms: Indianapolis,IN 46250 •4 4 Carmel Police Department!CARMEPD :` Pyoung@carmel.in.Gov (W) Exclusively Serving Public Safety Professionals Since 1990. MR,W- 01-:1_ �� r..�!- p'�•� �s ,.ate°..� 71i --�KG W e .01Audlome .81PFT-Pulmona Function Test .6Vision-Acui 1.21Vital Si ns-HT WT BP P R .00Mable Michael L. OnMe Proram 0.00UriI is-Di tide 3. 2EK W/Inte 4. Audiom $18-81 16.81 PFT-Pulmonary Function est •62 Vision-Aculy $31,21 $31.Z1 Vital Signs-HT WT OP P R . 0 ResbIrator/Medical Review 21 Health Risk Appraisal Medike r $0.00 $0.00 Comorehensive Physical Exam $117.64 $117. Mlstfft Ratio 3.62 .62 Body F t Test-BIA Bio-Elec Imp Anal 16.81 16.81 Treadmill-Sub ax $183.59 S183.591 Muscular Strencith Endurance Test $31.21 $31.21 Flexibility st $12.01 1 1 Chest - a -P I ' 2 $72.0 Mad O inl -Wellness $0.0 Med Opinion-R s r $0.00 Martin,Brian A. Mad O In -Wellness $0.00 $0,00 Med i n-R 0.00 Res iratodMedical Review $19.21 $19.21 Health Risk Appraisal Medikee r 0.00 $0.00 Comprehensive Physical Exam $117.64 1 $117.64 Waist/Hit) Ratio* N $3.62 Bo Fat Test-BIA Blo-EI c ImpAnal $16.81 readmill-Submax 1 9 usculer Stmn durance $31.2 Flexibilityest 12.01 t X-Ra -P DI Ital 02 Unna sis- tick 3.62 EKG 24.0 0 Audoornetry1 Public Safety Medical - INVOICE i.."� Public Safety Medical Invoice Date: 06/20/2018 6612 E.75th Street Invoice# 00-33105 = Floor 2' Terms: Indianapolis,IN 46250 qr Carmal Police Department I CARMEPD Pyoung@carmel.In.Gov (W) }' Exclusively Serving Public Safety Professionals Since 1990. •' t Ir C y.... yt t.-- .n Yl _•• �� .: sfl:id,�• 1 V..�-•'-. .. FT-P o Funct' t 2 `4•� Vision-Acuity $31.21 31.21 Vital Signs-HT WT BP P R 0.00 .00 OnMed Pr ram 0.00 0.00 - - Pads.Mark J. On Pro re 0.00 0.00 Res irato!Medical Review $19.21 19.21 Health Risk A lsal Medik er) $0-QQ $0.001 Commhensive Physical Exam ;9117.10614 177.641 Med -Wellness 0.00 Med inion- T 0.Me ion-Res i r 0.0 Walstl . 2 Bad Fat - Elec Imp16.81 16.8 Treadmill-Submax 183.59 $183.59 FleAbill Test 12.01 $1.2.01 Chest X-Ray-PA/LAT(Digital) 72.02 $72.0 Udnal sis-DI stick $3.62 $3.62 EKG W/Interp $24.01 $24.011 Audiometry 6.81 $16.81 .PFT-Pulmonmy Function Test $44.6 $44. Vision-A 31.21 $31.21 Vital Signs-HT YU BP P 13 90.000 enforth TneYQr M. OnMed PLUgram $0.00 $0.00. t r edi w Health Risk Appraisal r 0.00 0.0 Comprehensive Ph 'cal Exam $117.64 117.64 Med Opinion-Wellness $0.00 $0.00 Med Opinion-Respirator $0.00 $0.00 Wal i Ratio $3.62 $3.62 Bodv Fat Test-BI io-Elec Imp Anal 16.81 16.81 Treadmill-Subma 183.59 183.59 Flexibility Test 912.01 $12.01 Chest X-Ra - T(13initall $72.02 $72.02 Uinal Is-Di tick $3.62 %3,(6 EKG /In .0 2 .0 Au 16.8 P -Pulmonary Functign Test $44. 4 Public Safety Medical - INVOICE •; ; Publle Safety Medical Invoice Date: 06/20/2018 6692 E.75th Street Invoice# 00-33105 Floor 2 Terms: Indianapolis,IN 45250 rCarmel Police Department I CARMEPD I1l"Al Pyoung@carmel.In.Gov (W) Exclusively Serving Public Safety Professionals Since 1990. BRAT WEN Viion-Amity $31.21 $31.21 Vital Signs-HT WT BP P R 0.00 $0.00 Smith Troy D. Urinalysis-Di stick $3.62 $3.62 EKG W/Intek$24.01 24.01 Audi t 16.81 PFT-Pulmona Function Test 44.6Vision-Acu $31.21 Vaal Siang-HT WT BP P R $0.00 $0.00 OnMed Program $0,13D $0.00 Med inion-Wellness S0.00 Med Oninlon-SWAT $0.00 $0.00 Med Opinion-Respirator $0 0 0 ftstffil Ratio 6 Body Fat Test-BIA Bio-Elec Imp Anal 16.81 $16.81 Treadmill-Submax 183.59 $183.59 Flexibili Test 12.01 12.01 Chest X-Ray-PAILAT Di ital 72.02 2.0 Respirator/Medical Review $19.21 $19.21 Health Risk Aunralsal Medikee er 0.00 Comprehensive Physical Exam $117.64 117. -_ �:. �••• .�`.��1+='� � n..••n::r• _: ° ..r• �yS ! �_• j ( __e.. .._ ' ,� M- 111-- ce. 1�11-s'c�. . n ...raF- rO E'"tF . a.'al...si`.. 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.