HomeMy WebLinkAbout328099 07/25/18 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
$2,476.99
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
1�fl09�!`4= 33-33195 43-407.01 $576.38 1 hereby certify that the attached invoice(s),or 7/2/18 33-33195 officer physicals $576.38
1110 101 1110 101
100944 00-33222 43-407.01 $858.51 bill(s)is(are)true and correct and that the 7/10/18 00-33222 officer physicals $858.51
1110 101 materials or services itemized thereon for 1110 1 101
100944 I 00-33252 I 43-407.01 I $1,042.10 7/11/18 I 00-33252 I officer physicals I $1,042.10
1110 101 which charge is made were ordered and 1110 101
received except
Tuesday,July 24,2018
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
20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer
Public Safety Medical - INVOICE
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Indianapolis,IN 46250
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Carmel Police Department I CARMEPD
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Exclusively Serving Public Safety Professionals Since 9990.
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07/02/18 Brammer Wolf T er J. Indiana PERF Exam
Med Opinion-Post Offer-PERF $0.00 $0.00
Chart Review/Completion $97.22 $97.22
Respirator Clearance-SS A26.65 $26.6
Applicant Blood Panel-PERF $137.82 $137.82
Venipuncture $3.62 $3.62
antife n-Tb(Blood) 60. 1 $60.01
Drun Screen 9 +Oplates&QWadlone48.02 U8.0
Vital Si ns-HT WT BP P R 0
Vision-Aculty 931.21 31.21
-Vision- olor Is i a) $31.21 $31.21
PFT-Pulmonary Function Test $44.62 $A4.9
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,81
EKG W/Interp $24.01 $24.ol
Udna is-DI stick $3.62 $3.62
Tonomet Glaucoma Test .21 1 43.21
Chest X-Ray-PAItAT(Digital) 72.02 $72.02
modoreD vid A. Tread 'll-Submax $183.59 $183.59
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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
Public Safety Medical Invoice Date: 07/1012018
6612 E.75th Street Invoice# 00-33222
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Floor 2 Terms:
Indianapolis,IN 46250
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a` - Carmel Police Department I CARMEPD
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Exclusively Serving Public Safety Professionals Since 1990.
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Indiana PERF Exam $218.46
Med Opinion-Post Offer-PERF $0.00 $0.00
Chart Review/Completlon $97.22 $97.22
Respirator Clearance-SS 26.65 $26.65_
Applicant Blood Panel-PERF $137.82 $137.82
Venipuncture $3.62 $3.62
Ouantiferon-Tb Blood) $60.01
Drum Screen 9 +O fates&Oxycodone $48.02 $48.02
Vital Si ns-HT WT BPP 0.00
Visiori31.21 $31.21
s or s 1.21
PFT-Pulmonary Function Test
Audiometry $16.81 .81
EKG W/Interp $24.01 $24.01
Urinalysis-Dipstick $3.62 $3.62
Tonometry Glaucoma Test)--- 3.21 $43.21
Chest X-Ra -PA/I.AT(Digital) 72.02 $72.0
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Please write Invoice number on payment check. Our Federal Employer identification number is 35-2079797.
We greatly appreciate the opportunity fo serve you. If you have any questions regarding this invoice, please contact
Michelle McClure at 317-964-2364.
I
Public Safety Medical - INVOICE
o. Public Safety Medical Invoice Date: 07/02/2018 .
~' 6612 E.75th:Street
�= Invoice# 00-33195
= Floor 2 Term"s:
.� Indianapolis, IN 46260
Carmel Police Department/CARMEPD
10.
m Pyoung@carmel.In.Gov (W)
Exclusively Serving Public Safety Professionals Since 2996.
Date= Employee _ Description; Amount ';.`Balance Due;
1 Fosier.Johnathan A. OnMed Pro ram $0.00
Respirator/Medical Review 19:21 $.19.21
Heaith Risk Appraisal Wedikee er $0.00 $0.00
Com rehensive Physical Exam $117.64 $117.64
W/ Ia t/Hi Ratio $3.62 $3.62
Body Fat Test=BIA Bio-Elec Imp AnalO $16.81 $16.81
Treadmill-Submax 183.59 183.59
Muscular.Stren th Endurance Test $31.21 $31:21
Flexibility.,Test 12.01 $12.01
Chest X=Ra -PAILAT�biqjian $72.02 72.02
-Urinal sis=Di stick $J.62 $3.62
EkG Wh,
to 24.61 $24.01
Audiometry 16.81 $16.81
PFT-P&nonbry Function Test. $44.0. $44:62
vision_Acufty $31.21 $31.21
Vital Signs-HT WT BP P R 0.00 $0.00
Med-Opinion-Wellness 0.60 0.00
Med.O inion-SWAT 0:00 $0.00
Med Opinion-Res irator $b.00 4w.00
Total:Charges? $576 38;
T.. . .
_ otal Payments- Balance Due-> $0.00 '-__$576.38
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 31.7-964-2364.