The URL can be used to link to this page

Home My WebLink About332232 11/13/18 CITY OF CARMEL, INDIANA VENDOR: 00350364 %.° •,3 -`l ONE CIVIC SQUARE PUBLIC SAFETY MEDICAL SERVICES CHECK AMOUNT: $*****5,921.39* CARMEL, INDIANA 46032 6612 E.75TH STREET CHECK NUMBER: 332232 SUITE 200 CHECK DATE: 11/13/18 INDIANAPOLIS IN 46250 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1110 4340701 100944 00-33862 1,717.02 OFFICER PHYSICALS 1110 4340701 100944 00-33863 858.51 OFFICER PHYSICALS 1110 4340701 100944 00-33909 2,487.35 OFFICER PHYSICALS 1110 4340701 100944 00-33959 858.51 OFFICER PHYSICALS VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) Vendor# 00350364 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER PUBLIC SAFETY MEDICAL SERVICES IN SUM OF$ CITY OF CARMEL 324 E NEW YORK ST SUITE 300 An invoice or bill to be property 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 $5,921.39 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 00-33863 43-407.01 $858.51 1 hereby certify that the attached invoice(s),or 10/17/18 00-33863 officer physicals $858.51 1110 101 1110 101 100944 00-33862 43-407.01 $1,717.02 bill(s)is(are)true and correct and that the 10/17/18 00-33862 officer physicals $1,717.02 1110 101 materials or services itemized thereon for 1110 1 101 100944 00-33909 43-407.01 $2,487.35 10/25/18 00-33909 officer physicals $2,487.35 1110 101 which charge is made were ordered and 1110 101 100944• 00-33959 43-407.01 $858.51 received except 10/30/18 00-33959 officer physicals $858.51 1110 101 1110 101 Friday, November 2,2018 ac'..' Ia.. A.w 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 distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer Public Safety Medical - INVOICE o Public Safety Medical Invoice Date: 10/25/2018 + 6612 E.75th Street Invoice# 00-33909 E Floor 2 Terms: ~� w Indianapolis, IN 46250 1 C Carmel Police Department/CARMEPD Pyoung@carmel.In.Gov(W) m ' Exclusively Serving Public Safety Professionals Since 1990. Date Employee Description Amount Balance Due 10/15/18 Barlow James C. HIV-4th Gen Ra id Test Blood 26.58 $26.58 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 199E PSA-Prostate Specific A Blood 42.01 $42.01 Homer Jeffrey J. 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 Com Metabolic Panel 22.97 $22.97 PSA-Prostate S ecific A Blood 42.01 $42.01 Leach Aaron 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 $22.97 PSA-Prostate Specific A Blood 42.01 $42.01 McNair.Harland J. HIV-4th Gen Rapid Test Blood 26.58 $26.58 Venipuncture $3.62 $3.62 Lipid Panel Blood 24.42 $24.42 CBC(Corno Blood Count 20.80 $20.80 CMP Com Metabolic Panel 22.97 $22.97 PSA-Prostate S ecific A Blood 42.01 $42.01 Meyer,R an J. 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 Specific A Blood 42.01 $42.01 Pirics John D. 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(Como Blood Count 20.80 $20.80 CMP(Comp Metabolic Panel 22.97 $22.97 PSA-Prostate S ecific A Blood 42.01 $42.01 Jo a h n D. HIV-4th Gen aid Test(Blood) $26.5826.5 Public Safety Medical - INVOICE o ' Public Safety Medical Invoice Date: 10/25/2018 6612 E.75th Street Invoice# 00-33909 E Floor 2 dTerms: , w Indianapolis, IN 46250 Carmel Police Department/CARMEPD Pyoung@carmel.In.Gov(W) @ ' i Exclusively Serving Public Safety Professionals Since 1990. Date Employee Description Amount Balance Due GilbertWilliam J. 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 Hobson Phillip L. 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 Specific A Blood 42.01 $42.01 Howard Lana M. HIV-4th Gen Ra id Test Blood 26.58 $26.58 Venipuncture $3.62 $3.62 Lipid Panel Blood 24.42 1 $24.42 CBC(Comp Blood Count 20.80 $20.80 CMP(Comp Metabolic Panel 22.97 $22.97 Kinkade Matthew P. 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 Com Metabolic Panel 22.97 $22.97 McAllister John W. 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 PSA-Prostate Specific A Blood $42.01 $42.01 10/17/18 Barlow Cod J. Venipuncture $3.62 $3.621 Li id Panel Blood 24.42 $24.42 CBC(Comp Blood Count 20.80 $20.80 CMP(Comp Metabolic Panel 22.97 $22.97 Smiley,Landry D. 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 Com Blood Count 20.80 $20.80 CMP Co Metabolic Pa el 22.97 22. 7 Public Safety Medical - INVOICE o Public Safety Medical Invoice Date: 10/25/2018 6612 E.75th Street Invoice# 00-33909 E ; Floor 2 Terms: W Indianapolis, IN 46250 t i Carmel Police Department/CARMEPD I Pyoung@carmel.In.Gov(W) m Exclusively Serving Public Safety Professionals Since 1990. Date Employee Description Amount 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 Striker Nicholas W. 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 Zellers Nancy L. 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 10/16/18 Bay,Christo her A. 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(Comp Metabolic Panel 22.97 $22.971 Bickel Joseph E. 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(Corno Blood Count 20.80 $20.80 CMP(Comp Metabolic Panel 22.97 $22.97 PSA-Prostate S ecific A Blood 42.01 $42.01 Brady,Sean P. 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 Specific A Blood 42.01 $42.01 Clark Sr. Todd C. HIV-4th Gen Ra id Test Blood) $26.58 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 PSA-Prostate Sgecific A (Blood) $42.01 $42.01 Public Safety Medical - INVOICE o ' Public Safety Medical Invoice Date: 10/25/2018 d w 6612 E.75th Street Invoice# 00-33909 j E , Floor 2 Terms: y" W Indianapolis, IN 46250 r - Carmel Police Department/CARMEPD 0" Pyoung@carmel.In.Gov(W) m Exclusively Serving Public Safety Professionals Since 1990. Date Employee Description ' Amount Balance Due PSA-Prostate S ecific A Blood 42.01 42.01 Total Charges-? $2,487.35 Total Payments&Balance Due=> $0.00 $2,487.35 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 -- --_ i o i Public Safety Medical Invoice Date: 10/17/2018 6612 E.75th Street Invoice# 00-33863 E Floor 2 Terms: w Indianapolis, IN 46250 µ Y Carmel Police Department/CARMEPD ~ Pyoung@carmel.In.Gov(W) m ' Exclusively Serving Public Safety Professionals Since 1990. Date Employee Description Amount Balance Due 10/09/18 Trezise Ashle W. Indiana PERF Exam $218.46 $218.46 Med Opinion-Post Offer-PERF $0.00 $0.00 Chart Review/Completion $97.22 $97.22 Respirator Clearance-SS $26.65 $26.65 Applicant Blood Panel-PERF $137.82 $137.82 Venipuncture $3.62 $3.62 Quantiferon-Tb Blood 60.01 $60.01 Drug Screen 9 +Opiates&Oxycodone $48.02 $48.02 Vital Signs-HT WT BP P R $0.00 $0.00 Vision-Acuity 31.21 $31.21 Vision-Color Ishihara 31.21 $31.21 PFT-Pulmonary Function Test $44.62 $44.62 Audiometry 16.81 $16.81 EKG W/Interp $24.01 1 $24.01 Urinalysis-Dipstick $3.62 $3.62 Tonometry Glaucoma Test 43.21 $43.21 Chest X-Ray-PA/LAT(Digital) 72.02 $72.02 -Total Charges-> . $858.51 Total Payments&BalanceDue->` $0.00 $858.51 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: 10/17/2018 w 6612 E.75th Street Invoice# 00-33862 E Floor 2 Terms: IY Indianapolis, IN 46250 f o Carmel Police Department/CARMEPD F- Pyoung@carmel.In.Gov(W) m ' Exclusively Serving Public Safety Professionals Since 1990. Date Employee Description Amount Balance Due 10/11118 Jellison Shelb L. Med O inion-Post Offer-PERF $0.00 $0.00 Respirator Clearance-SS $26.65 $26.65 Chart Review/Completion $97.22 $97.22 Indiana PERF Exam $218.46 $218.46 Druq Screen 9 +Opiates&Oxvcodone $48.02 $48.02 Venipuncture $3.62 $3.62 A licant Blood Panel-PERF $137.82 $137.82 Quantiferon-Tb Blood 60.01 $60.01 Chest X-Ray-PA/LAT(Digital) 72.02 $72.02 Tonometry Glaucoma Test 43.21 $43.21 Urinalysis-Dipstick $3.62 $3.62 EKG W Inte 24.01 $24.01 Audiometry 16.81 $16.81 PFT-PulmonarV Function Test $44.62 $44.62 Vision-Color Ishihara $31.21 $31.21 Vision-Acuity 31.21 $31.21 Vital Signs-HT WT BP P R $0.00 $0.00 10/12/18 Edwards Turner A. Med Opinion-Post Offer-PERF $0.00 $0.00 Res irator Clearance-SS $26.65 $26.65 Chart Review/Completion $97.22 $97.22 Indiana PERF Exam $218.46 $218.46 Druci Screen 9 +O fates&Oxvcodone $48.02 $48.02 Tonomet Glaucoma Test 43.21 43.21 Urinal sis-Di stick $3.62 $3.62 EKG W Intern 24.01 $24.01 Audiometry $16.81 $16.81 PFT-Pulmonary Function Test $44.62 $44.62 Vision-Color Ishihara 31.21 $31.21 Vision-Acuity 31.21 31.21 Vital Signs-HT WT BP P R 0.00 0.00 Venipuncture 3.62 3.62 A licant Blood Panel-PERF 137.82 137.82 Quantiferon-Tb Blood 60.01 60.01 Chest X-Ray-PA/LAT(Digital) 72.02 $72.02 Total Charges-> $1,717.02 Total Payments&Balance Due->. $0.00 $1,717.02 Public Safety Medical - INVOICE oo Public Safety Medical Invoice Date: 10/30/2018 6612 E.75th Street Invoice# 00-33959 E Floor 2 Terms: � Indianapolis, IN 46250 o Carmel Police Department/CARMEPD F- Pyoung@carmel.In.Gov(W) m , Exclusively Serving Public Safety Professionals Since 1990. Date Employee Description Amount Balance Due 10/25/18. Larrison,Chase E. Indiana PERF Exam $218.46 $218.46 Med Opinion-Post Offer-PERF $0.00 $0.00 Chart Review/Completion $97.22 $97.22 Respirator Clearance-SS $26.65 $26.65 Applicant Blood Panel-PERF $137.82 $137.82 Venipuncture $3.62 $3.62 Quantiferon-Tb Blood 60.01 $60.01 Drug Screen 9 +Opiates&Oxycodone $48.02 $48.02 Chest X-Ray-PA/LAT(Digital) 72.02 $72.02 Vital Si ns-HT WT BP P R $0.00 so.001 Vision-Acuitv $31.21 $31.21 Vision-Color Ishihara 31.21 $31.21 PFT-Pulmonary Function Test $44.62 $44.62 Audiornetry $16.81 $16.81 EKG W/Interp $24.01 $24.01 Urinalysis-Dipstick $3.62 3.62 Tonomet Glaucoma Test 43.21 43.21 Total.Charges-> $858.51 Total Payments&Balance Due-> $0.00 $858.51 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.