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Home My WebLink About329979 09/13/18 qAM CITY OF CARMEL, INDIANA VENDOR: 367222 �/ ONE CIVIC SQUARE IU HEALTH WORKPLACE SERVICES LLCCHECK AMOUNT: $....65,110.41' i�; CARMEL, INDIANA 46032 2046 RELIABLE PKWY CHECK NUMBER: 329979 '';��TON�` CHICAGO IL 60686-0020 CHECK DATE: 09/13/18 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 301 5023990 763873 46,411.61 OTHER EXPENSES 1201 4358800 763874 90.00 TESTING FEES 301 5023990 763875 75.00 OTHER EXPENSES 301 5023990 763898 14,914.87 OTHER EXPENSES 1205 4347500 763932 941.05 GENERAL INSURANCE 301 5023990 763960 1,266.90 OTHER EXPENSES 301 5023990 763995 1,410.98 OTHER EXPENSES VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) Vendor# 367222 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER IU HEALTH WORKPLACE SERVICES LLC IN SUM OF$ CITY OF CARMEL 2046 RELIABLE PKWY An invoice or bill to be properly itemized must show:kind of service,where perfonned,dates service rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc. CHICAGO, IL 60686-0020 Payee $941.05 Purchase Order# ON ACCOUNT OF APPROPRIATION FOR General Administration 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 763932 43-475.00 $941.05 1 hereby certify that the attached invoice(s),or 8/31/18 763932 EAP Aug 2018 $941.05 1205 101 1205 101 bill(s)is(are)true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except Thursday,September 6,2018 Crider,James Administration I hereby certify that the attached invoice(s),or bill(s),is(are)true and correct and I have audited same in accordance with IC 5-11-10-1.6 20 Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer Indiana University Health Workplace Services,LLC5 714 N.Senate Avenue Suite 200 Indianapolis, IN 46202 317-963-1535 Tax I D# 20-0994452 Invoice August 31, 2018 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite EAP Services/Aug.2018 1 Civic Square Carmel,IN 46032- Invoice# 763932 Service Date Description Quanti Charge Recein Adjust Balance 08/01/2018 EAP Services 649.00 941.05 941.05 CITYCARO Invoice# 763932 Balance Due: 941.05 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK To SEP 0 5 2018 le r, �° � � VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) Vendor# 367222 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER IU HEALTH WORKPLACE SERVICES LLC IN SUM OF$ CITY OF CARMEL 2046 RELIABLE PKWY 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. CHICAGO, IL 60686-0020 Payee $90.00 Purchase Order# ON ACCOUNT OF APPROPRIATION FOR Human Resources Terms Date Due PO# ACCT# DATE INVOICE# DESCRIPTION DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND#r (or note attached invoice(s)or bill(s)) AMOUNT 763874 43-588.00 $90.00 1 hereby certify that the attached invoice(s),or 8/31/18 763874 Onsite Occupational UDS Aug 2018 $90.00 1201 101 1201 101 bill(s)is(are)true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except Thursday,September 6,2018 CA-4` c� Crider,James Administration I hereby certify that the attached invoice(s),or bill(s),is(are)true and correct and I have audited same in accordance with IC 5-11-10-1.6 20 Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer Indiana University Health Workplace Services,LLC 714 N.Senate Avenue Suite 200 )2�1 Indianapolis, IN 46202 317-963-1535 Tax ID# 20-0994452 Invoice August 31, 2018 Bill to: Barbara Lamb For: City of Cannel-Onsite City of Carmel-Onsite Occupational UDS/Aug.2018 1 Civic Square Carmel,IN 46032- Invoice# 763874 Service Date Description Quantity Charge Recei Ad"us Balance 08/02/2018 Quick Read UDS/6panel 15.00 S, bin IIn'edTo F SEP 0 5 2018 Invoice# 763874(continued)page 2 Service Date Description Quanti h r e Recei Aw-u—st Balance CITYCARO Invoice# 763874 Balance Due: 90.00 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) Vendor# 367222 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER IU HEALTH WORKPLACE SERVICES LLC IN SUM OF$ CITY OF CARMEL 2046 RELIABLE PKWY 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. CHICAGO, IL 60686-0020 Payee $64,079.36 ON ACCOUNT OF APPROPRIATION FOR Purchase Order# 301 Medical Fund Terms 301 Medical Fund Date Due PO# ACCT# DATE INVOICE# DESCRIPTION DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT 763995 50-239.90 $1,410.98 1 hereby certify that the attached invoice(s),or 8/31/18 763995 Onsite Billing Aug 2018 $1,410.98 301 301 301 301 763960 50-239.90 $1,266.90 bill(s)is(are)true and correct and that the 8/31/18 763960 Onsite PEPM Aug 2018 $1,266.90 301 301 materials or services itemized thereon for 301 301 763898 50-239.90 $14,914.87 8/31/18 763898 Onsite Misc Aug 2018 $14,914.87 301 301 which charge is made were ordered and 301 301 763875 50-239.90 $75.00 received except 8/31/18 763875 Onsite Wellness UDS Aug 2018 $75.00 301 301 301 301 763873 50-239.90 $46,411.61 8/31/18 763873 Onsite Staff Aug 2018 $46,411.61 301 301 301 301 Thursday,September 6,2018 CA- CL�Q Crider,James Administration 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 �l Indiana University Health Workplace Services, LLC � 714 N.Senate Avenue Suite 200 Indianapolis, IN 46202 317-963-1535 Tax ID# 20-0994452 Invoice August 31, 2018 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite On-Site Billing/Aug.2018 1 Civic Square Carmel,IN 46032- Invoice# 763995 Service Date Description Quanti Charge Receip Ad'us Balance 08/01/2018 Onsite Operating Supplies 1.00 1,036.98 1036.98 August 2018 Supplies 08/01/2018 Onsite Facility Operations 1.00 374.00 374.00 August 2018 Facility Charges CITYCARO Invoice# 763995 Balance Due: 1410.98 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK FSubrinibled, To SEP 0 5 2018 �l Indiana University Health Workplace Services,LLC —� 714 N.Senate Avenue Suite 200 Indianapolis, IN 46202 317-963-1535 Tax I D# 20-0994452 Invoice August 31, 2018 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite PEPM/August 2018 1 Civic Square Carmel,IN 46032- Invoice# 763960 Service Date Description Quantily Charae Recei Ad'us Balance 08/01/2018 Monthly Wellness PEPM 618.00 1,266.90 1266.90 CITYCARO Invoice# 763960 Balance Due: 1266.90 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK U wakted, T SEP 0 5 2018 Chow _ p�aa�gi o gai KP *,� J i S� Indiana University Health Workplace Services,LLC 714 N.Senate Avenue Suite 200 Indianapolis, IN 46202 317-963-1535 Tax I D# 20-0994452 Invoice August 31, 2018 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Misc.Onsite/August 2018 1 Civic Square Carmel,IN 46032- Invoice# 763898 Service Date Description Quanti Charge Recei AdLu-sl Balance 06/13/2018 AS Medical Solutions Mail-In Meds 1.00 2,513.81 2513.81 06/27/2018 AS Medical Solutions Clinic Meds 1.00 19.15 19.15 07/01/2018 Onsite Lab Charges 1.00 4,270.40 4270.40 July 2018 Labs 07/31/2018 AS Medical Solutions Clinic Meds 1.00 748.32 748.32 07/31/2018 Video Visit 1.00 49.00 49.00 July 2018 Video Visits 08/01/2018 Utility Expenses 1.00 500.18 500.18 08/01/2018 Building Expenses 1.00 1,086.87 1086.87 08/01/2018 Lease Expense 1.00 4,316.05 4316.05 08/02/2018 AS Medical Solutions Clinic Meds 1.00 42.88 42.88 08/10/2018 AS Medical Solutions Clinic Meds 1.00 91.91 91.91 08/16/2018 AS Medical Solutions Clinic Meds 1.00 1,276.30 1276.30 CITYCARO Invoice# 763898 Balance Due: 14914.87 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK Lc I-1a�� To SEP0 5 2018 rk 4i reasur Indiana University Health Workplace Services,LLC 714 N.Senate Avenue _361 Suite 200 Indianapolis, IN 46202 317-963-1535 Tax ID# 20-0994452 Invoice August 31, 2018 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Wellness UDS/Aug.2018 1 Civic Square Carmel,IN 46032- Invoice# 763875 Service Date Description Quanti Charae Recei Ad"Us Balance 08/27/2018 Quick Read UDS/6panel includes 1.00 15.00 15.00 kit 15.00 Subi-nifted To CI CARO Invoice# 763875 Balance Due: 75.00 MAKEAYMENBib_' ifflROW ADD SS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE OICE#ON CHECK ClA rer Indiana University Health Workplace Services,LLC 714 N.Senate Avenuel Suite 200 Indianapolis, IN 46202 317-963-1535 Tax ID# 20-0994452 Invoice August 31, 2018 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Staff Time/August 2018 1 Civic Square Carmel,IN 46032- Invoice# 763873 Service Date Description Quanti Charge Receip Aw-US Balance 08/01/2018 Health Coach Staff Time 1.00 65.92 65.92 Kristin Hullett 08/01/2018 N.P.Staff Time 8.75 1,015.53 1015.53 Tina Nitsos 08/01/2018 R.N.Staff Time 9.50 606.67 606.67 Stacey Neese 08/01/2018 M.A.Staff Time 7.35 211.97 211.97 Kimberly Pride 08/02/2018 N.P.Staff Time 4.50 522.27 522.27 Tina Nitsos 08/02/2018 R.N.Staff Time 5.25 335.27 335.27 Stacey Neese 08/02/2018 M.A.Staff Time 4.50 129.78 129.78 Kimberly Pride 08/03/2018 M.A.Staff Time 5.50 158.62 158.62 Maria Collins 08/03/2018 Health Coach Staff Time 4.00 263.68 263.68 Kristin Hullett 08/03/2018 N.P.Staff Time 6.00 696.36 696.36 Tina Nitsos 08/03/2018 MD Staff Time 5.00 901.25 901.25 Dr.Moody 08/03/2018 R.N.Staff Time 6.25 399.13 399.13 Stacey Neese 08/03/2018 M.A.Staff Time 5.20 149.97 149.97 Kimberly Pride 08/06/2018 M.A.Staff Time 8.27 238.51 238.51 Kimberly Pride 08/06/2018 N.P.Staff Time 4.50 522.27 522.27 Tina Nitsos 08/06/2018 R.N.Staff Time 10.00 638.60 638.60 Stacey Neese Submitted To SEP..O5 2018 Invoice# 763873 (continued)page 2 Service Date Description Quantity Charae R cei Atu-sl Balance 08/06/2018 Health Coach Staff Time 7.00 461.44 461.44 Kristin Hullett 08/06/2018 MD Staff Time 5.00 901.25 901.25 Dr.Moody 08/07/2018 M.A.Staff Time 8.02 231.30 231.30 Kimberly Pride 08/07/2018 N.P.Staff Time 5.00 580.30 580.30 Sheila Abebe 08/07/2018 N.P.Staff Time 5.50 638.33 638.33 Tina Nitsos 08/07/2018 R.N.Staff Time 9.00 574.74 574.74 Stacey Neese 08/08/2018 M.A.Staff Time 4.00 115.36 115.36 Von McCain 08/08/2018 M.A.Staff Time 4.20 121.13 121.13 Kimberly Pride 08/08/2018 N.P.Staff Time 9.25 1,073.56 1073.56 Tina Nitsos 08/08/2018 R.N.Staff Time 10.00 638.60 638.60 Stacey Neese 08/09/2018 M.A.Staff Time 4.50 129.78 129.78 Von McCain 08/09/2018 M.A.Staff Time 4.60 132.66 132.66 Kimberly Pride 08/09/2018 N.P.Staff Time 4.00 464.24 464.24 Carla Cork 08/09/2018 R.N.Staff Time 4.50 287.37 287.37 Stacey Neese 08/10/2018 M.A.Staff Time 5.30 152.85 152.85 Kimberly Pride 08/10/2018 M.A.Staff Time 5.10 147.08 147.08 Maria Collins 08/10/2018 N.P.Staff Time 5.75 667.35 667.35 Tina Nitsos 08/10/2018 R.N.Staff Time 6.50 415.09 415.09 Stacey Neese 08/10/2018 Health Coach Staff Time 5.00 329.60 329.60 Kristin Hullett 08/10/2018 MD Staff Time 5.00 901.25 901.25 Dr.Moody 08/13/2018 M.A.Staff Time 7.78 224.38 224.38 Kimberly Pride 08/13/2018 N.P.Staff Time 4.25 493.26 493.26 Tina Nitsos 08/13/2018 R.N.Staff Time 9.50 606.67 606.67 Stacey Neese 08/13/2018 Health Coach Staff Time 7.00 461.44 461.44 Kristin Hullett Invoice# 763873 (continued)page 3 Service Date Description uanti Charge Recei Adiust Balance 08/13/2018 MD Staff Time 5.00 901.25 901.25 Dr.Moody 08/14/2018 M.A.Staff Time 7.23 208.51 208.51 Kimberly Pride 08/14/2018 N.P.Staff Time 5.00 580.30 580.30 Sheila Abebe 08/14/2018 N.P.Staff Time 5.50 638.33 638.33 Tina Nitsos 08/14/2018 R.N.Staff Time 9.00 574.74 574.74 Stacey Neese 08/14/2018 Health Coach Staff Time 1.50 98.88 98.88 Kristin Hullett 08/15/2018 M.A.Staff Time 8.00 230.72 230.72 Yon McCain 08/15/2018 N.P.Staff Time 9.00 1,044.54 1044.54 Tina Nitsos 08/15/2018 R.N.Staff Time 10.00 638.60 638.60 Stacey Neese 08/16/2018 M.A.Staff Time 4.20 121.13 121.13 Kimberly Pride 08/16/2018 N.P.Staff Time 4.50 522.27 522.27 Tina Nitsos 08/16/2018 R.N.Staff Time 4.25 271.41 271.41 Stacey Neese 08/17/2018 M.A.Staff Time 5.00 144.20 144.20 Kimberly Pride 08/17/2018 M.A.Staff Time 5.00 144.20 144.20 Maria Collins 08/17/2018 N.P.Staff Time 5.50 638.33 638.33 Tina Nitsos 08/17/2018 R.N.Staff Time 6.00 383.16 383.16 Stacey Neese 08/17/2018 Health Coach Staff Time 3.50 230.72 230.72 Kristin Hullett 08/17/2018 MD Staff Time 5.00 901.25 901.25 Dr.Moody 08/20/2018 MD Staff Time 5.00 901.25 901.25 Dr.Moody 08/20/2018 N.P.Staff Time 4.50 522.27 522.27 Tina Nitsos 08/20/2018 R.N.Staff Time 10.00 638.60 638.60 Stacey Neese 08/20/2018 Health Coach Staff Time 7.00 461.44 461.44 Kristin Hullett 08/20/2018 M.A.Staff Time 8.33 240.24 240.24 Kimberly Pride 08/21/2018 R.N.Staff Time 9.00 574.74 574.74 Yon McCain Invoice# 763873 (continued)page 4 Service Date Description Quant! Charae Receipt us Balance 08/21/2018 N.P.Staff Time 5.00 580.30 580.30 Kaneshiro 08/21/2018 N.P.Staff Time 5.50 638.33 638.33 Tina Nitsos 08/21/2018 M.A.Staff Time 10.40 299.94 299.94 Kimberly Pride 08/22/2018 N.P.Staff Time 9.25 1,073.56 1073.56 Tina Nitsos 08/22/2018 R.N.Staff Time 9.50 606.67 606.67 Stacey Neese 08/22/2018 M.A.Staff Time 8.33 240.24 240.24 Kimberly Pride 08/23/2018 MD Staff Time 4.00 721.00 721.00 Dr.Darroca 08/23/2018 R.N.Staff Time 4.50 287.37 287.37 Stacey Neese 08/23/2018 M.A.Staff Time 4.30 124.01 124.01 Kimberly Pride 08/24/2018 M.A.Staff Time 5.00 144.20 144.20 Takisha Fisher 08/24/2018 R.N.Staff Time 5.00 319.30 319.30 Cindy Moon 08/24/2018 MD Staff Time 5.00 901.25 901.25 Dr.Moody 08/24/2018 N.P.Staff Time 5.75 667.35 667.35 Tina Nitsos 08/24/2018 Health Coach Staff Time 5.00 329.60 329.60 Kristin Hullett 08/24/2018 M.A.Staff Time 5.40 155.74 155.74 Kimberly Pride 08/27/2018 MD Staff Time 5.00 901.25 901.25 Dr.Moody 08/27/2018 N.P.Staff Time 4.25 493.26 493.26 Tina Nitsos 08/27/2018 R.N.Staff Time 10.00 638.60 638.60 Stacey Neese 08/27/2018 Health Coach Staff Time 7.00 461.44 461.44 Kristin Hullett 08/27/2018 M.A.Staff Time 8.32 239.95 239.95 Kimberly Pride 08/28/2018 R.N.Staff Time 4.00 255.44 255.44 Von McCain 08/28/2018 N.P.Staff Time 5.00 580.30 580.30 Sheila Abebe 08/28/2018 N.P.Staff Time 5.50 638.33 638.33 Tina Nitsos 08/28/2018 R.N.Staff Time 5.00 319.30 319.30 Stacey Neese Invoice# 763873 (continued)page 5 Service Date Description Quanti Charge Recei Aw-u-st Balance 08/28/2018 M.A.Staff Time 8.40 242.26 242.26 Kimberly Pride 08/29/2018 N.P.Staff Time 9.00 1,044.54 1044.54 Tina Nitsos 08/29/2018 R.N.Staff Time 9.50 606.67 606.67 Stacey Neese 08/29/2018 M.A.Staff Time 8.12 234.18 234.18 Kimberly Pride 08/30/2018 N.P.Staff Time 4.50 522.27 522.27 Tina Nitsos 08/30/2018 R.N.Staff Time 4.50 287.37 287.37 Stacey Neese 08/30/2018 M.A.Staff Time 3.40 98.06 98.06 Kimberly Pride 08/31/2018 M.A.Staff Time 5.00 144.20 144.20 Von McCain 08/31/2018 MD Staff Time 5.00 901.25 901.25 Dr.Moody 08/31/2018 N.P.Staff Time 5.50 638.33 638.33 Tina Nitsos 08/31/2018 R.N.Staff Time 6.00 383.16 383.16 Stacey Neese 08/31/2018 Health Coach Staff Time 5.00 329.60 329.60 Kristin Hullett 08/31/2018 M.A.Staff Time 5.10 147.08 147.08 Kimberly Pride CITYCARO Invoice# 763873 Balance Due: 46411.61 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK