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HomeMy WebLinkAbout334089 01/04/19 � CITY OF CARMEL, INDIANA VENDOR: 367222 ONE CIVIC SQUARE IU HEALTH WORKPLACE SERVICES LLCCHECK AMOUNT: $*****1,012.15* CARMEL, INDIANA 46032 2046 RELIABLE PKWY CHECK NUMBER: 334089 CHICAGO IL 60686-0020 CHECK DATE: 01/04/19 ITON� DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1201 4358800 764544 74.00 TESTING FEES 1205 4347500 764578 938.15 GENERAL INSURANCE VOUCHER NO. WARRANT NO. Prescribed by state Board of Accounts City Form No.201(Rev.1995) Vendor# 367222 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER IU HEALTH WORKPLACE SERVICES LLC IN SUM OF$ 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 $74.00 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 764544 43-588.00 $74.00 I hereby certify that the attached invoice(s),or 12/31/18 764544 Onsite Occ UDS Dec 2018 $74.00 1201 101 Prior-Year, 1201 101 bill(s)is(are)true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except Thursday,January 3,2019 Lamb, Barbara Director I hereby certify that the attached invoice(s),or bill(s),is(are)true and correct and I have audited same in accordance with IC 5-11-10-1.6 ,20 Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer Indiana University Health Workplace Services,LLC -Sal 714 N.Senate Avenue l Z Suite 200 Indianapolis, IN 46202 317-963-1535 Tax I D# 20-0994452 Invoice December 31, 2018 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Occupational UDS/Dec.2018 1 Civic Square Carmel,IN 46032- Invoice# 764544 Service Date Description Quanti Charge Receip Adjust Balance 12/10/2018 Quick Read UDS/6panel includes 74.00 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK Submitted To JAN 0 3 2019 Clerk TreaSurer _. Cnt and rntnm with--tit VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) ALLOWED 20 ACCOUNTS PAYABLE VOUCHER Vendor# 367222 'IU HEALTH WORKPLACE SERVICES LLC IN SUM OF$ 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 $938.15 ON ACCOUNT OF APPROPRIATION FOR Purchase Order# 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 764578 43-475.00 $938.15 1 hereby certify that the attached invoice(s),or 12/31/18 764578 EAP Services $938.15 1205 101 Prior Year 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 Thursday,January 3,2019 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 z��5 714 N.Senate Avenue 11 Suite 200 z�=� Indianapolis, IN 46202 317-963-1535 Tax ID# 20-0994452 Invoice December 31, 2018 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite EAP Services/Dec.2018 1 Civic Square Carmel,IN 46032- Invoice# 764578 Service Date Description Quanti Charae Recelp MAMA Balance 12/01/2018 EAP Services 647.00 938.15 938.15 CITYCARO Invoice# 764578 Balance Due: 938.15 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK Submitted To JAN 0 3 2019 Clerk Treasurer