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Home My WebLink About328584 08/09/18 CITY OF CARMEL, INDIANA VENDOR: 00350364 • ONE CIVIC SQUARE PUBLIC SAFETY MEDICAL SERVICES CHECK AMOUNT: $*****2,986.80* CARMEL, INDIANA 46032 6612 E.75TH STREET CHECK NUMBER: 328584 °M,�TON-�o• SUITE 200 CHECK DATE: 08/09/18 INDIANAPOLIS IN 46250 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1110 4340701 100944 00-33326 2,872.98 OFFICER PHYSICALS 1110 4340701 100944 00-33364 113.82 OFFICER PHYSICALS VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) Vendor# 00350364 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER PUBLIC SAFETY MEDICAL SERVICES IN SUM OF$ 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 $2,986.80 Purchase Order# ON ACCOUNT OF APPROPRIATION FOR 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 00-33326 43-407.01 $2,872.98 1 hereby certify that the attached invoice(s),or 7/25/18 00-33326 officer physicals $2,872.98 1110 101 1110 101 100944 00-33364 43-407.01 $113.82 bill(s)is(are)true and correct and that the 8/1/18 00-33364 officer physicals $113.82 1110 101 1 materials or services itemized thereon for 1110 1 101 which charge is made were ordered and received except Tuesday,August 7,2018 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 5-11-10-1.6 120 Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer Public Safety Medical - INVOICE t°- . Public Safety Medical Invoice Date: 08/01/2018 6612 E.75th Street Invoice# 00-33364 E Floor 2 Terms: Indianapolis, IN 46250 f o Carmel Police Department/CARMEPD t— m Pyoung@carmel.In.Gov (W) Exclusively Serving Public Safety Professionals Since 1990. . Date - Employee Description Amount Balance Due 07/24/18 Amos Chad B. Veni uncture $3.62 $3.62 Lipid Panel Blood $24.42 $24.42 CBC(Comp Blood Count $20.80 $20.80 CMP(Comp Metabolic Panel 22.97 $22.97 PSA-Prostate Specific A Blood 42.01 $42.011 Total Charges $113.82 Total-Payments&Balance Due >1 -$0.001 $113.82 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 0 , Public Safety Medical Invoice Date: 07/25/2018 6612 E.75th Street Invoice# 00-33326 E. Floor 2 Terms: M Indianapolis, IN 46250 r o Carmel Police Department/CARMEPD H - Pyoung@carmel.In.Gov (W) m Exclusively Serving Public Safety Professionals Since 1990. Date Employee Description Amount Balance Due. 07/16/18 Broadnax Matthew L. Veni uncture $3.62 $3.62 Lipid Panel Blood $24.42 $24.42 CBC Comp Blood Count $20.80 $20.80 CMP(Como Metabolic Panel 22.97 $22.97 PSA-Prostate Specific A Blood 42.01 $42.01 Devenport,Adam M. HIV-4th Gen Rapid Test Blood 26.58 $26.58 Venipuncture $3.62 $3.62 Lipid Panel Blood 24.42 $24.42 CBC(Como Blood Count 20.80 $20.80 CMP(Como Metabolic Panel 22.97 $22.97 Gerdt Andrew P. HIV-4th Gen Ra id Test Blood 26.58 $26.58 Veni uncture $3.62 $3.62 Li id Panel Blood 24.42 $24.42 CBC(Como Blood Count $20.80 $20.80 CMP(Como Metabolic Panel $22.97 $22.97 PSA-Prostate Specific A Blood 42.01 $42.01 Harris Robert P. HIV-4th Gen Ra id Test Blood 26.58 $26.58 Venipuncture $3.62 $3.62 Lipid Panel Blood 24.42 $24.42 CBC(Como Blood Count 20.80 $20.80 CMP(Como Metabolic Panel 22.97 $22.97 PSA-Prostate Specific A Blood 42.01 $42.01 Ha maker William E. Venipuncture $3.62 $3.62 Li id Panel Blood 24.42 $24.42 CBC(Como Blood Count 20.80 $20.80 CMP(Como Metabolic Panel $22.97 $22.97 PSA-Prostate Specific A Blood $42.01 $42.01 Kin on David M. HIV-4th Gen Rapid Test Blood $26.58 19L2 Veni uncture $3.62 $3.621 Li id Panel Blood 24.42 $24.42 CBC(Como Blood Count 20.80 $20.80 CMP(Como Metabolic Panel 22.97 $22.9 Re nolds Jamie N. Veni uncture $3.62 $3.62 Li id Panel Blood 24.42 24.42 CBC(Como Blood Count 20.80 $20.80 CMP(Como Metabolic Panel 22.97 $22.97 Rodriauez. is IV-4th Gen Rapid es I 9 RJR A Public Safety Medical - INVOICE o Public Safety Medical Invoice Date: 07/25/2018 _ 6612 E.75th Street Invoice# 00-33326 E ; Floor 2 Terms: W. Indianapolis, IN 46250 Carmel Police Department/CARMEPD 0 Pyoung@carmel.In.Gov (W) m: Exclusively Serving Public Safety Professionals Since 1990. Date. Employee Description Amounf . .;Balance,Due Veni uncture $3.62 $3.62 Li id Panel Blood $24.42 $24.42 CBC(Comp Blood Count $20.80 $20.80 CMP(Comp Metabolic Panel 22.97 $22.97 Spillman,R. Scott HIV-4th Gen Rapid Test Blood 26.58 $26.58 Venipuncture $3.62 $3.62 Li id Panel Blood 24.42 $24.42 CBC(Comp Blood Count $20.80 $20.80 CMP Com Metabolic Panel 22.97 $22.97 PSA-Prostate Specific A Blood 42.01 $42.011 Vanderbeck David R. HIV-4th Gen Rapid Test Blood 26.58 $26.58 Venipuncture $3.62 $3.62 Li id Panel Blood 24.42 $24.42 CBC(Comp Blood Count $20.80 $20.80 CMP(Comp Metabolic Panel $22.97 $22.97 PSA-Prostate Specific A Blood 42.01 $42.01 07/17/18 Byrne,Timothy L. HIV-4th Gen Rapid Test Blood) $26.58 Venipuncture $3.62 $3.62 Li id Panel Blood 24.42 $24.42 CBC C mp Blood Count 20.80 $20.80 CMP(Comp Metabolic Panel 22.97 $22.97 PSA-Prostate S ecific A Blood 42.01 $42.01 Dewald Greaory S. HIV-4th Gen Rapid Test Blood 26.58 $26.58 Veni uncture $3.62 $3.62 Lind Panel Blood 24.42 $24.42 CBC(Comp Blood Count $20.80 $20.80 CMP(Comp Metabolic Panel 22.97 $22.97 PSA-Prostate Specific A Blood $42.01 $42.01 Gossett Lucas A. HIV-4th Gen Rapid Test Blood 26.58 $26.58 Venipuncture $3.62 $3.62 Li id Panel Blood 24.42 $24.42 CBC(Comp Blood Count 20.80 $20.80 CMP(Comp Metabolic Panel 22.97 $22.9 Grose James E. HIV-4th Gen Rapid Test Blood 26.58 $26.58 Veni uncture $3.62 $3.62 Lipid Panel Blood 24.4224.42 CB C Blood Count) 0 $20.801 Public Safety Medical - INVOICE ' o ' Public Safety Medical Invoice Date: 07/25/2018 e 6612 E.75th Street Invoice# 00-33326 1= Floor 2 Terms: W. Indianapolis, IN 46250 o Carmel Police Department/CARMEPD F- m Pyoung@carmel.In.Gov (W) Exclusively Serving Public Safety Professionals Since 1990. .Date'- Employee. DescriptionAmount Balance Due CMP(Comp Metabolic Panel 22.97 $22.97 PSA-Prostate Specific A Blood $42.01 $42.01 Lytle,Blake A. HIV-4th Gen Rapid Test Blood $26.58 $26.58 Veni uncture $3.62 $3.62 Li id Panel Blood 24.42 $24.42 CBC(Comp Blood Count 20.80 $20.80 CMP(Comp Metabolic Panel 22.97 $22.97 Morrow Scott A. HIV-4th Gen Rapid Test Blood 26.58 $26.58 Veni uncture $3.62 $3.62 Livid Panel Blood 24.42 $24.42 CBC(Comp Blood Count 20.80 $20.80 CMP(Como Metabolic Panel 22.97 $22.97 Rush Michael T. HIV-4th Gen Ra id Test Blood 26.58 26.58 Venipuncture $3.62 $3.62 Lipid Panel Blood 24.42 $24.42 CBC(Comp Blood Count 20.80 $20.80 CMP(Comp Metabolic Panel 22.97 $22.97 PSA-Prostate Specific A Blood 42.01 $42.01 Schmidt Brian E. HIV-4th Gen Rapid Test Blood 26.58 $26.58 Venipuncture $3.62 $3.62 Lipid Panel Blood 24.42 $24.42 CBC Com Blood Count 20.80 $20.80 CMP(Comp Metabolic Panel 22.97 $22.97 PSA-Prostate S ecific A Blood 42.01 $42.01 07/18/18 Babczak Brian M. HIV-4th Gen Ra id Test Blood 26.58 $26.58 Venipuncture $3.62 $3.62 Li id Panel Blood $24.42 $24.42 CBC(Comp Blood Count 20.80 $20.80 CMP(Comp Metabolic Panel 22.97 22.97 Locke Robert E. HIV-4th Gen Rapid Test Blood 26.58 $26.58 Venipuncture $3.62 $3.62 Lipid Panel Blood 24.42 $24.42 CBC(Comp Blood Count 20.80 $20.80 CMP(Comp Metabolic Panel 22.97 $22.97 PSA-Prostate S ecific A Blood 42.01 $42.01 Lovitt Richard A. HIV-4th Gen Rapid Test Blood 26.58 $26.58 Venipuncture 62 S1.62 Public Safety Medical - INVOICE o Public Safety Medical Invoice Date: 07/25/2018 6612 E.75th Street Invoice# 00-33326 E Floor 2 Terms: Indianapolis, IN 46250 o : Carmel Police Department/CARMEPD m Pyoung@carmel.In.Gov (W) Exclusively Serving Public Safety Professionals Since 9990. Date Employee Description Amount Balance Due Li id Panel Blood 24.42 $24.42 CBC(Comp Blood Count $20.80 $20.80 CMP(Comp Metabolic Panel 22.97 $22.97 PSA-Prostate Specific A Blood) $42.01 Matthews Daniel M. HIV-4th Gen Rapid Test Blood 26.58 $26.58 Venipuncture $3.62 $3.62 Lipid Panel Blood 24.42 $24.42 CBC(Comp Blood Count 20.80 $20.80 CMP(Comp Metabolic Panel 22.97 $22.971 Morley,Michael W. Venipuncture $3.62 $3.62 Li id Panel Blood 24.42 $24.42 CBC Com Blood Count 20.80 $20.80 CMP Com Metabolic Panel 22.97 $22.97 Morris James D. HIV-4th Gen Rapid Test Blood $26.58 $26.58 Venipuncture $3.62 $3.62 Li id Panel Blood 24.42 $24.42 CBC(Comp Blood Count 20.80 $20.80 CMP(Comp Metabolic Panel 22.97 $22.97 Vantreese Dustin Venipuncture $3.62 $3.62 Lipid Panel Blood 24.42 $24.42 CBC(Comp Blood Count 20.80 20.80 CMP(Comp Metabolic Panel 22.97 $22.97 Total Charges-> , $2,872.98' Total Payments&Balance Due->, $0.00 $2,872.98 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.