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Home My WebLink About331670 10/25/18 CITY OF CARMEL, INDIANA VENDOR: 00350364 J� ONE CIVIC SQUARE PUBLIC SAFETY MEDICAL SERVICES CHECK AMOUNT: $*******716.78* CARMEL, INDIANA 46032 6612 E.75TH STREET CHECK NUMBER: 331670 SUITE 200 CHECK DATE: 10/25/18 INDIANAPOLIS IN 46250 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1110 4340701 100944 0033762 576.38 OFFICER PHYSICALS 1110 4340701 100944 0033815 140.40 OFFICER PHYSICALS VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) Vendor# 00350364 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER PUBLIC SAFETY MEDICAL SERVICES IN SUM OF$ 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 $716.78 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 00-33762 43-407.01 $576.38 1 hereby certify that the attached invoice(s),or 10/4/18 00-33762 officer physicals $576.38 1110 101 1110 101 100944 00-33815 43-407.01 $140.40 bill(s)is(are)true and correct and that the 10/10/18 00-33815 officer physicals $140.40 1110 1 101 1 materials or services itemized thereon for 1110 1 101 which charge is made were ordered and received except Wednesday,October 17,2018 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 (,.o ; Public Safety Medical Invoice Date: 10/10/2018 r 6612 E.75th Street Invoice# 00-33815 Floor 2 Terms: Indianapolis, IN 46250 1 p -o Carmel Police Department/CARMEPD I Pyoung@carmel.In.Gov(W) m Exclusively Serving Public Safety Professionals Since 1990. Date Employee Description, Amount" Balance Due 10/03/18 Schalbura.Randy S. 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(Comp Blood Count 20.80 $20.80 CMP(Como Metabolic Panel 22.97 22.97 PSA-Prostate Specific A Blood 42.01 42.01 Total Cfiarges-> -$140.40 Total Payments&:Balance Due-> ':.- $0;00, $140.40 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 o' Public Safety Medical Invoice Date: 10/04/2018 6612 E.75th Street Invoice# 00-33762 E Floor 2 Terms: .d i. tx : Indianapolis, IN 46250 Carmel Police Department/CARMEPD F- ? Pyoung@carmel.In.Gov(W) Exclusively Serving Public Safety Professionals Since 1990. Date Employee -`Description Amount Balance Due. 09124/18. Byrne.Timothy L. OnMed Pro ram $0.00 $0.00 Respirator/Medical Review $19.21 $19.21 Health Risk Appraisal Medikee er $0.00 $0.00 Comprehensive Physical Exam $117.64 $117.64 Med Opinion-Wellness $0.00 $0.00 Med Opinion-Respirator $0.00 $0.00 Waist/Hi Ratio $3.62 $3.62 Body Fat Test-BIA Bio-Elec Im Anal 16.81 $16.81 Treadmill-Submax 183.59 $183.59 Muscular Strength Endurance Test 31.21 $31.21 Flexibility Test $12.01 $12.01 Chest X-Ray-PA/LAT Di i al 72.02 $72.02 Urinal sis-Di stick $3.62 $3.62 EKG W/Interp $24.01 $24.01 AudiometrV $16.81 $16.81 PFT-Pulmonary Function Test $44.62 $44.62 Vision-Acuity 31.21 $31.21 Vital Signs-HT WT BP P R $0.00 0.00 ->' Total ChargeS $576.38' 'Total 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 317-964-2364.