HomeMy WebLinkAbout332232 11/13/18 CITY OF CARMEL, INDIANA VENDOR: 00350364
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•,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.