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HomeMy WebLinkAbout333111 12/11/18 CITY OF CARMEL, INDIANA VENDOR: 367222 .�; �• ONE CIVIC SQUARE IU HEALTH WORKPLACE SERVICES LLCCHECK AMOUNT: $*******986.05* 9� ?� CARMEL, INDIANA 46032 2046 RELIABLE PKWY CHECK NUMBER: 333111 Mi�ioN�o• CHICAGO IL 60686-0020 CHECK DATE: 12/11/18 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1201 4358800 764324 45.00 TESTING FEES 1205 4347500 764383 941.05 GENERAL INSURANCE VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) Vendor# 367222 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER IU HEALTH WORKPLACE SERVICES LLC IN SUM OF$ 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 $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 764383 43-475.00 $941.05 1 hereby certify that the attached invoice(s),or 11/30/18 764383 EAP Nov 2018 $941.05 1205 101 1205 101 bill(s)is(are)true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except Tuesday, December 4,2018 LA4--dc�i Crider,James Administration I hereby certify that the attached invoice(s),or bill(s),is(are)true and correct and I have audited same in accordance with IC 5-11-10-1.6 ,20— Cost 20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer Indiana University Health Workplace Services,LLC 714 N.Senate Avenue ?.S Suite 200 Indianapolis, IN 46202 317-963-1535 Tax ID# 20-0994452 Invoice November 30, 2018 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite EAP Services/Nov.2018 1 Civic Square Carmel,IN 46032- Invoice# 764383 Service Date Description Quanti Charge Recelp Adjust Balance 11/01/2018 EAP Services 649.00 941.05 941.05 CITYCARO Invoice# 764383 Balance Due: 941.05 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK i To DEC 0 5 2018 VOUCHER NO. WARRANT NO. Prescribed by state Board of Accounts City Form No.201(Rev.1995) Vendor# 367222 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER IU HEALTH WORKPLACE SERVICES LLC IN SUM OF$ 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 $45.00 ON ACCOUNT OF APPROPRIATION FOR Purchase Order# Human Resources 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 764324 43-588.00 $45.00 1 hereby certify that the attached invoice(s),or 11/30/18 764324 Testing $45.00 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 Tuesday, December 4,2018 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 20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer Indiana University Health Workplace Services,LLC 714 N.Senate Avenue —SSS Suite 200 >-2 Indianapolis, IN 46202 317-963-1535 Tax ID# 20-0994452 Invoice November 30, 2018 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Occupational UDS/Nov.2018 1 Civic Square Carmel,IN 46032- Invoice# 764324 Service Date Description uanti Charae Recei Ad"Us Balance 10/02/2018 Quick Read UDS/6panel includes 1.00 15.00 15.00 kit 45.00 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK FT it" r;, iT ! I DEC J 5 2018 1 Cb, ^cr gid: