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Home My WebLink About331904 11/07/18 CITY OF CARMEL, INDIANA VENDOR: 367222 ONE CIVIC SQUARE IU HEALTH WORKPLACE SERVICES LLCCHECK AMOUNT: $****75,320.19* CARMEL, INDIANA 46032 2046 RELIABLE PKWY CHECK NUMBER: 331904 CHICAGO IL 60686-0020 CHECK DATE: 11/07/18 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 301 5023990 754221 22,159.86 OTHER EXPENSES 301 5023990 764167 50,536.34 OTHER EXPENSES 301 5023990 764238 1,234.10 OTHER EXPENSES 301 5023990 764254 15.00 OTHER EXPENSES 301 5023990 764289 1,374.89 OTHER EXPENSES VOUCHER NO. WARRANT NO. Prescribed by state Board of Accounts City Form No.201(Rev.1995) Vendor# 367222 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER IU HEALTH WORKPLACE SERVICES LLC IN SUM OF$ CITY OF CARMEL 2046 RELIABLE PKWY An invoice or bill to be properly itemized must show:kind of service,where 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 $75,320.19 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 764167 50-239.90 $50,536.34 1 hereby certify that the attached invoice(s),or 10/31/18 764167 Oct 2018 Onsite Staff $50,536.34 301 301 301 301 754221 50-239.90 $22,159.86 bill(s)is(are)true and correct and that the 10/31/18 754221 Oct 2018 Onsite Misc $22,159.86 301 301 materials or services itemized thereon for 301 301 764238 50-239.90 $1,234.10 10/31/18 764238 Oct 2018 Onsite PEPM $1,234.10 301 301 which charge is made were ordered and 301 301 764254 50-239.90 $15.00 received except 10/31/18 764254 Oct 2018 Onsite Wellness UDS $15.00 301 301 301 301 764289 50-239.90 $1,374.89 10/31/18 764289 Oct 2018 Onsite Billing $1,374.89 301 301 301 301 Tuesday, November 6,2018 Lamb, Barbara Director 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 -30 Suite 200 Indianapolis, IN 46202 317-963-1535 Tax ID# 20-0994452 Invoice October 31, 2018 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Staff Time/Oct.2018 1 Civic Square Carmel,IN 46032- Invoice# 764167 Service Date Description Quanti Charge Recelp Adjust Balance 10/01/2018 R.N.Staff Time 10.00 638.60 638.60 Jenny Broome 10/01/2018 N.P.Staff Time 4.50 522.27 522.27 Tina Nitsos 10/01/2018 Health Coach Staff Time 7.50 494.40 494.40 Kristin Hullett 10/01/2018 MD Staff Time 5.00 901.25 901.25 Dr.Moody 10/01/2018 M.A.Staff Time 9.30 268.21 268.21 Kimberly Pride 10/02/2018 R.N.Staff Time 9.00 574.74 574.74 Jenny Broome 10/02/2018 N.P.Staff Time 5.50 638.33 638.33 Tina Nitsos 10/02/2018 Health Coach Staff Time 1.50 98.88 98.88 Kristin Hullett 10/02/2018 MD Staff Time 5.00 901.25 901.25 Dr.Moody 10/02/2018 M.A.Staff Time 8.58 247.45 247.45 Kimberly Pride 10/03/2018 R.N.Staff Time 10.00 638.60 638.60 Brummell 10/03/2018 M.A.Staff Time 8.35 240.81 240.81 Elizabeth Herald 10/03/2018 N.P.Staff Time 9.00 1,044.54 1044.54 Tina Nitsos 10/03/2018 MD Staff Time 5.00 901.25 901.25 Dr.Moody 10/03/2018 M.A.Staff Time 8.87 255.81 255.81 Kimberly Pride 10/04/2018 MD Staff Time 4.00 721.00 721.00 Dr.Moody g b: d NOV 0 5 2018 ti W �' Invoice# 764167(continued)page 2 Service Date Description Quanti Charae Recelp Adjust Balance 10/04/2018 M.A.Staff Time 5.00 144.20 144.20 Amber Helton 10/04/2018 M.A.Staff Time 4.60 132.66 132.66 Kimberly Pride 10/05/2018 R.N.Staff Time 5.00 319.30 319.30 Candice Shockley 10/05/2018 N.P.Staff Time 6.00 696.36 696.36 Tina ,Nitsos 10/05/2018 M.A.Staff Time 6.30 181.69 181.69 Amber Helton 10/08/2018 N.P.Staff Time 4.50 522.27 522.27 Tina Nitsos 10/08/2018 MD Staff Time 5.00 901.25 901.25 Dr.Moody 10/08/2018 R.N.Staff Time 10.50 670.53 670.53 Stacey Neese 10/08/2018 M.A.Staff Time 8.20 236.49 236.49 Katherine Kelly 10/09/2018 N.P.Staff Time 5.50 638.33 638.33 Tina Nitsos 10/09/2018 MD Staff Time 5.00 901.25 901.25 Dr.Moody 10/09/2018 R.N.Staff Time 9.75 622.64 622.64 Stacey Neese 10/09/2018 M.A.Staff Time 8.45 243.70 243.70 Kimberly Pride 10/10/2018 M.A.Staff Time 5.60 161.50 161.50 Elizabeth Herald 10/10/2018 N.P.Staff Time 8.50 986.51 986.51 Tina Nitsos 10/10/2018 MD Staff Time 5.00 901.25 901.25 Dr.Moody 10/10/2018 R.N.Staff Time 10.25 654.57 654.57 Stacey Neese 10/10/2018 M.A.Staff Time 8.52 245.72 245.72 Kimberly Pride 10/11/2018 MD Staff Time 4.00 721.00 721.00 Dr.Moody 10/11/2018 R.N.Staff Time 5.00 319.30 319.30 Stacey Neese 10/11/2018 M.A.Staff Time 4.10 118.24 118.24 Kimberly Pride 10/12/2018 M.A.Staff Time 5.30 152.85 152.85 Kimberly Pride 10/12/2018 N.P.Staff Time 5.75 667.35 667.35 Tina Nitsos 10/12/2018 Health Coach Staff Time 5.00 329.60 329.60 Kristin Hullett Invoice# 764167(continued)page 3 Service Date Descdptio Quanti Charge Recei Ad"us Balance 10/12/2018 R.N.Staff Time 6.00 383.16 383.16 Stacey Neese 10/15/2018 N.P.Staff Time 4.50 522.27 522.27 Tina Nitsos 10/15/2018 MD Staff Time 5.00 901.25 901.25 Dr.Moody 10/15/2018 Health Coach Staff Time 7.50 494.40 494.40 Kristin Hullett 10/15/2018 R.N.Staff Time 10.50 670.53 670.53 Stacey Neese 10/15/2018 M.A.Staff Time 9.00 259.56 259.56 Brummel 10/16/2018 N.P.Staff Time 5.50 638.33 638.33 Tina Nitsos 10/16/2018 MD Staff Time 5.00 901.25 901.25 Dr.Moody 10/16/2018 R.N.Staff Time 10.50 670.53 670.53 Stacey Neese 10/16/2018 M.A.Staff Time 9.30 268.21 268.21 Betty Hartley 10/17/2018 N.P.Staff Time 9.25 1,073.56 1073.56 Tina Nitsos 10/17/2018 MD Staff Time 5.00 901.25 901.25 Dr.Moody 10/17/2018 R.N.Staff Time 9.75 622.64 622.64 Stacey Neese 10/17/2018 M.A.Staff Time 5.50 158.62 158.62 Elizabeth Herald 10/17/2018 M.A.Staff Time 4.00 115.36 115.36 Von McCain 10/17/2018 M.A.Staff Time 4.40 126.90 126.90 Karol Magyar 10/18/2018 MD Staff Time 4.00 721.00 721.00 Dr.Moody 10/18/2018 R.N.Staff Time 5.25 335.27 335.27 Stacey Neese 10/18/2018 M.A.Staff Time 4.00 115.36 115.36 Brummel 10/19/2018 N.P.Staff Time 5.50 638.33 638.33 Tina Nitsos 10/19/2018 R.N.Staff Time 6.00 383.16 383.16 Stacey Neese 10/19/2018 M.A.Staff Time 5.00 144.20 144.20 Von McCain 10/22/2018 N.P.Staff Time 4.50 522.27 522.27 Tina Nitsos 10/22/2018 MD Staff Time 5.00 901.25 901.25 Dr.Moody Invoice# 764167(continued)page 4 Service Date Description Quanti Charge Recelp Adjust Balance 10/22/2018 Health Coach Staff Time 7.00 461.44 461.44 Kristin Hullett 10/22/2018 M.A.Staff Time 8.30 239.37 239.37 Maria Collins 10/22/2018 R.N.Staff Time 10.25 654.57 654.57 Stacey Neese 10/23/2018 N.P.Staff Time 5.50 638.33 638.33 Tina Nitsos 10/23/2018 MD Staff Time 5.00 901.25 901.25 Dr.Moody 10/23/2018 M.A.Staff Time 8.57 247.16 247.16 Maria Collins 10/23/2018 R.N.Staff Time 9.75 622.64 622.64 Stacey Neese 10/24/2018 N.P.Staff Time 8.50 986.51 986.51 Tina Nitsos 10/24/2018 MD Staff Time 5.00 901.25 901.25 Dr.Moody 10/24/2018 M.A.Staff Time 8.63 248.89 248.89 Elizabeth Herald 10/24/2018 M.A.Staff Time 5.30 152.85 152.85 Maria Collins 10/24/2018 R.N.Staff Time 10.00 638.60 638.60 Stacey Neese 10/25/2018 MD Staff Time 4.00 721.00 721.00 Dr.Moody 10/25/2018 M.A.Staff Time 4.30 124.01 124.01 Maria Collins 10/25/2018 R.N.Staff Time 4.75 303.34 303.34 Stacey Neese 10/26/2018 N.P.Staff Time 5.75 667.35 667.35 Tina Nitsos 10/26/2018 Health Coach Staff Time 5.00 329.60 329.60 Kristin Hullett 10/26/2018 M.A.Staff Time 2.70 77.87 77.87 Maria Collins 10/26/2018 R.N.Staff Time 5.25 335.27 335.27 Stacey Neese 10/29/2018 M.A.Staff Time 8.50 245.14 245.14 Maria Collins 10/29/2018 R.N.Staff Time 10.25 654.57 654.57 Stacey Neese 10/29/2018 N.P.Staff Time 4.50 522.27 522.27 Tina Nitsos 10/29/2018 MD Staff Time 5.00 901.25 901.25 Dr.Moody 10/29/2018 Health Coach Staff Time 7.50 494.40 494.40 Kristin Hullett Invoice# 764167(continued)page 5 Service Date DescriptionQuant! Charge Recelp AWS Balance 10/30/2018 M.A.Staff Time 8.28 238.80 238.80 Maria Collins 10/30/2018 R.N.Staff Time 10.00 638.60 638.60 Stacey Neese 10/30/2018 N.P.Staff Time 5.50 638.33 638.33 Tina Nitsos 10/30/2018 MD Staff Time 5.00 901.25 901.25 Dr.Moody 10/31/2018 M.A.Staff Time 5.80 167.27 167.27 Elizabeth Herald 10/31/2018 M.A.Staff Time 8.50 245.14 245.14 Maria Collins 10/31/2018 R.N.Staff Time 10.00 638.60 638.60 Stacey Neese 10/31/2018 N.P.Staff Time 9.25 1,073.56 1073.56 Tina Nitsos 10/31/2018 MD Staff Time 5.00 901.25 901.25 Dr.Moody CITYCARO Invoice# 764167 Balance Due: 50536.34 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK Indiana University Health Workplace Services,LLC 3,1 714 N.Senate Avenue Suite 200 Indianapolis, IN 46202 317-963-1535 Tax ID# 20-0994452 Invoice October 31, 2018 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Misc.Onsite/Oct.2018 1 Civic Square Carmel,IN 46032- Invoice# 764221 Service Date Description Quantily Charge Recei Ad"Us Balance 09/01/2018 Onsite Lab Charges 1.00 2,750.28 2750.28 September 2018 Labs 09/26/2018 AS Medical Solutions Clinic Meds 1.00 916.50 916.50 09/28/2018 AS Medical Solutions Mail-In Meds 1.00 5,864.38 5864.38 10/01/2018 Building Expenses 1.00 1,086.87 1086.87 10/01/2018 Lease Expense 1.00 4,316.05 4316.05 10/01/2018 Utility Expenses 1.00 538.82 538.82 10/01/2018 Enhanced Care-Urgent Care Visits 1.00 2,641.20 2641.20 10/05/2018 AS Medical Solutions Clinic Meds 1.00 1,080.16 1080.16 10/10/2018 AS Medical Solutions Clinic Meds 1.00 15.02 15.02 10/12/2018 AS Medical Solutions Clinic Meds 1.00 716.33 716.33 10/18/2018 AS Medical Solutions Mail-In Meds 1.00 1,887.73 1887.73 10/18/2018 AS Medical Solutions Clinic Meds 1.00 346.52 346.52 CITYCARO Invoice# 764221 Balance Due: 22159.86 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK ib ian,14H- NOV 0 5 2018 Indiana University Health Workplace Services,LLCM 714 N.Senate Avenue _ Suite 200 Indianapolis, IN 46202 317-963-1535 Tax ID# 20-0994452 Invoice October 31, 2018 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite PEPM/Oct.2018 1 Civic Square Carmel,IN 46032- Invoice# 764238 Service Date Description anti Charcie Recelp Aw-u-sl Balance 10/01/2018 Monthly Wellness PEPM 602.00 1,234.10 1234.10 CITYCARO Invoice# 764238 Balance Due: 1234.10 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK i 9-on itt' � d f Nov 0 2018 � gal, Treasurer � Indiana University Health Workplace Services, LLC 714 N.Senate Avenue Suite 200 3J� Indianapolis, IN 46202 317-963-1535 Tax ID# 20-0994452 Invoice October 31, 2018 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Wellness UDS/Oct.2018 1 Civic Square Carmel,IN 46032- Invoice# 764254 Service Date Description Quantily Charge Recei Ad"Us Balance 10/03/2018 Quick Read UDS/6panel includes 1.00 15.00 15.00 kit 15.00 CITYCARO Invoice# 764254 Balance Due: 15.00 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK NOV 0 5 2018 p ��ii Treas.,urer Indiana University Health Workplace Services,LLC 714 N.Senate Avenue Suite 200. Indianapolis, IN 46202 317-963-1535 Tax ID# 20-0994452 Invoice October 31, 2018 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite On-Site Billing/Oct.2018 1 Civic Square Carmel,IN 46032- Invoice# 764289 Service Date Description anti Charge Recei AW-UBalance 10/01/2018 Onsite Facility Operations 1.00 340.00 340.00 October 2018 Facility Charges 10/01/2018 Onsite Operating Supplies 1.00 1,034.89 1034.89 October 2018 Supplies CITYCARO Invoice# 764289 Balance Due: 1374.89 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK NOV 0 5 2018 L, nom_