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HomeMy WebLinkAbout190552 09/29/2010 CITY OF CARMEL, INDIANA VENDOR: 00350364 Page 1 of 1 ONE CIVIC SQUARE PUBLIC SAFETY MEDICAL SERVICES CHECK AMOUNT: $66,505.02 CARMEL, INDIANA 46032 INDIANAPOLIS RN T O41TE 300 CHECK NUMBER: 190552 CHECK DATE: 9/29/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1120 4340701 24104 10 -10228 7,344.00 EXAMS 1120 4340701 24104 13410 9,756.36 EXAMS 1120 4340701 24104 13513 23,293.72 EXAMS 1120 4340701 24104 13561 17,072.56 EXAMS 1120 4340701 24104 13600 16,602.86 EXAMS 1091 4340700 13601 195.00 MEDICAL FEES 1120 4340701 24104 13647 5,267.44 EXAMS 1081 4340700 13648 65.00 MEDICAL FEES 1110 4340701 13694 1,636.08 MEDICAL EXAM FEES 1110 4340701 CRHERRON -40.00 MEDICAL EXAM FEES INVOICE H Public Safety Medical Services 324 E. New York Street E Suite 300 Indianapolis, IN 46204 O Carmel Police Department/ CARMEPD _F 3 Civic Square Terms Carmel, IN 46032 Invoice Date 09!2212010 m Invoice 00 -13694 Date Employee Description Amount Balance Due 06/16/10 Schalburg Randy S. CMP $15.30 15.30 CBC W /Dill And Plat $12.24 $12.24 Lipid Panel $15.30 $15.3 0 Veni uncture Fee $3.06 $3.06 HIV 1 &2 $13.26 $13.26 Q uantiferon Tb Gold $51.00 $51.00 09/16/10 Brady, Sean P. CMP $15.30 $15.3 0 CBC W /Diff And Plat $12.24 $12.24 Li id Panel $15.30 $15.3 0 Veni un i re Fee $3.06 $3.06 V1 Quantiferon Tb Gold $51.00 $51.00 Broadnax Matthew L CMP $15.30 $15.3 0 CBC W /Diff And Plat $12.24 $12.24 Lipid Panel $15.30 15.30 Veni uncture Fee $3.06 $3.06 Quantiferon Tb Gold 51.00 $51.0 0 Cash Steven H. CMP $15.30 $15.30 CBC W /Diff And Plat $12.24 $12.24 Li id Pane! $15.30 $15.30 Veni uncture Fee $3.06 $3.06 HIV 1 2 ---$13.2 $13.26 Go ld $5 1.00 Clark Sr, Todd C. Veni uncture Fee $3.06 $3.06 HIV 1 2 $13.26 $13.26 Quantiferon Tb Gold $51.00 $51.00 CMP $15.30 153 0 CBC WIDiff And Plat $12.24 $12.24 Lipid Panel 15.30 $15.3 0 Dixon Micheal R. CMP S15.30 $15.30 CBC WIDiff And Plat $12.24 $12.24 Li id Panel 15.30 $15.3 0 Veni uncture Fee 13.06 $3.06 HIV 1 2 $13.26 $13.26 PSA $35 70 $35.7 Quantiferon Tb Gold $51.00 $51.00 Green Timothy J. CMP $15.30 $15.30 CBC WIDiff And Plat $12.24 $12.24 Lipid Pane! $15.30 $15.3 0 Veni uncture Fee $3.06 $3,06 HIV 1 2 $13.26 13.26 PSA $35.70 $35.70 Q uantiferon Tb Gold $51.00 $51.00 Herron. James C. CMP $15.30 $15.3 0 CBC WIDiff And Plat $12.24 S12.24 Li id Pane! $15.30 $15.30 w INVOICE 0 Public Safety Medical Services 324 E. New York Street d Suite 300 W Indianapolis, IN 46204 G Carmel Police Department/ CARMEPD F 3 Civic Square Terms Carmel, IN 46032 Invoice Date 09122/2010 m Invoice 00 -13694 Date Employee Description Amount Balance Due Veni uncture Fee $3,06 $3.06 HIV 1 2 $13.26 $13.26 uantiferon Tb Gold 151.00 $51.0 0 Horne r P $15.30 $1 CBC W /Dill And Plat $12.24 $12.24 Lipid Panel $15.30 1 $15.30 Veni uncture Fee $3.06 $3.06 HIV 1 2 $13.26 $13,26 Quantiferon Tb Gold $51.00 $51.0 0 Jellison Ryan 0. CMP 15.30 $15.3 0 CBC W /Dill And Plat $12.24 $12.24 Lipid Panel $15.30 S15.30 Veni uncture Fee $3.06 $3.06 HIV 1 2 $13.26 $13.26 uantiferon Tb G 51.00 $51.00 K lein, A. CIVIP $15.30 $1 CBC WIDiff And Plat $12.24 $12.24 Lipid Panel $15.30 $15.30 Veni uncture Fee $3.06 $3.06 HIV 1 2 13.26 $13.26 Quantiferon Tb Gold $51.00 $51.00 Myers, Brady R. CMP $15.30 $15.301 CBC WIDiff And Plat 12.24 12.24 Lipid Panel $15.30 15.30 Veni uncture Fee $3.06 3.06 HIV 1 &2 $13,26 $13.26 Q uantiferon Tb Gold $51.00 $51.00 Schal 1 CBC WIDiff And Plat $12.24 $12.24 Lipid Panel $15.30 1 $15.30 Veni uncture Fee $3.06 $3.06 HIV 1 2 13.26 $13.26 Quantiferon Tb Gold $51.00 51.00 Schmidt, Brian E. CMP $15.30 $15.3 0 CBC W /Dill And Plat $12.24 $12,241 Lipid Panel $15.30 $15.30 Veni uncture Fee $3.06 $3.06 HIV 1 2 $13.26 $13.26 PSA $35.70 $35.70 Q,a ntiferon Tb Gold Total Charges $1,636.08 Total Payments &Balance Due $0.00 $1,636.08 Please write invoice number on payment check. Balance due 15 days from invoice Our Federal Employer Identification Number is 35- 2079797 date Public Safety Medical Services, Inc. HNVONCE 324 E. New York Suite 300 Invoice Number: CRHERRON Indianapolis, IN 46204 Invoice Date: Sep 14, 2010 TIN 35-2079797 Page: Voice: 1-317-972-1180 Duplicate Fax: 1-317-972-1190 6 :to Carmel Police Department 3 Civic Square Carmel, IN 46032 3D Ib" CARMEPD Nell 30 Days '77 7 S hip Date' Due )aW: ilesRep']O Method Courier 10/14/10 Q uantity credit for no-show fee on James Herron -40.00 Subtotal -40.00 Sales Tax Total Invoice Amount -40.00 Check/Credit Memo No: Payment/Credit Applied .4 O-Z Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995) ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL 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. Payee PUblic Safety Medical Services Purchase Order No. 324 E. New York Street, Suite 30&1 Terms Indianapolis, IN 46204 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 9/22/10 13694 payment for officer Rhysicals 1,636.08 9/14/10 CRHERRON less credit -40.00 Total 1,596.08 1 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 Clerk- Treasurer VOUCHER NO. WARRANT NO. ALLOWED 20 Pu blic Safety Medical Services IN SUM OF 324 E. New York Street, Suite 300 Indianapolis, IN 46204 1,596.08 ON ACCOUNT OF APPROPRIATION FOR po general fund Board Members PO# or INVOICE NO. ACCT /TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or 1110 13694 407 -01 1 636.08 bill(s) is (are) true and correct and that the 1110 CREERRON 407 -01 -40.00 materials or services itemized thereon for which charge is made were ordered and received except September 24 20 10 Signature Chief of Police Cost distribution ledger classification if Title claim paid motor vehicle highway fund t S INVOICE 0 Public Safety Medical Services 324 E. New York Street E Suite 300 tY Indianapolis, IN 46204 0 Carmel Clay Parks Recreation 1 CARMELPARK 1411E 116th Street Terms Carmel, IN 46032 invoice Date 09109!2010 m Invoice 00 -13601 Date Employee Description Amount Balance Due 09/01/10 Roudebush Dana R. Hepatitis B Vaccination #1 $65.00 65.00 In ection Fee 0.00 100 09/03/10 Barber, Amanda No -Show Fee $0.00 Commons Allie Hepatitis B Vaccination 41 $65.00 65.00 In ection Fee 0.00 $0.00 McLean, Dennis M. Hepatitis B Vaccination #1 $65.00 $65.00 In ection Fee $0.00 $0.00 Total Charges $195.00 Total Payments Balance Due $0.00 $195.00 Please write invoice number on payment check. Our Federal Employer Identification Number is 35- 2079797 W(fflM SEP 1 Q 2010 P. a0 ParF y C Pis :.....................o p App rov es INVOICE 0 Public Safety Medical Services 324 E. New York Street E Suite 300 W Indianapolis, IN 46204 O Carmel Clay Parks Recreation 1 CARMELPARK F 1411E 116th Street Terms Carmel, IN 46032 Invoice Date 09/14/2010 m Invoice 00 -13648 Date Employee Description Amount Balance Due 09/07/10 Sandberg. David S. Hepatitis B Vaccination #1 $65.00 $65.00 hection Fee som $0.00 Total Charges $65.00 Total Payments Balance Due $0.00 $65.00 Please write invoice number on payment check. Our Federal Employer Identification Number is 35- 2079797 An Q-5� SEP 1 5 2010 BY: Purchase 1. 5_ Description P.O. P ur F era et S Llne U Purche Date to ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice of 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. Payee Purchase Order No. 00350364 Public Safety Medical Services Terms 324 E. New York Street, Ste 300 Indianapolis, IN 46204 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO Amount 919110 13601 Medical fees 195.00 9114110 13648 Medical fees 65.00 Total 260.00 1 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_ Clerk- Treasurer Voucher No. Warrant No. 00350364 Public Safety Medical Services Allowed 20 324 E. New York Street, Ste 300 Indianapolis, IN 46204 In Sum of 260.00 ON ACCOUNT OF APPROPRIATION FOR 109 Monon Center 108 ESE PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members Dept 1091 13601 4340700 195.00 1 hereby certify that the attached invoice(s), or 1081 -99 13648 4340700 65.00 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 23 -Sep 2010 Signature 260.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund Public Safety Medical Services, Inc. INVOICE 324 E. New York Suite 300 Invoice Number: 10 -10228 Indianapolis, IN 46204 Invoice Date: Aug 24, 2010 TIN 35- 2079797 Page: 1 Voice: 1- 317 -972 -1180 Duplicate Fax: 1 -317- 972 -1190 T O t` "'p. 4 .u• a 'c2 s n p 7, t z s a mes:,.: s Carmel Fire Department 2 Civic Square Carmel, IN 46032 I �a Customer ID Customer PQ 5�. Payment Terms 1i, w CARMEFD Net 30 Days E Safes Re _ID Shi in Method ShE �Datev Due Date pi? pg� a ,ae Courier 9123/10 .C2uar�tity� F ,:..,aDescr�pt�on Un�tPrice z Amount w Refund for 144 quantiferon tests at $51.00 7,344.00 per I Subtotal 7,344.00 Sales Tax Total Invoi Amount 7,344. Check Credit Memo No: Payment /Credit Applied TOTAL ON INVOICE H Public Safety Medical Services a 324 E. New York Street E Suite 300 d Indianapolis, IN 46204 o Carmel Fire Department CARMEFD 2 Civic Square Terms Carmel, IN 46032 Invoice Date 08/1112010 Invoice 00 -13410 Date Employee Description Amount Balance Due PSA $35.70 $35.70 uantiieron Tb Gold $51.00 $51.0Q Walker. Christo her E. CMP $19,52 $19,52 C K W' iff And Plat $17.68 $17.68 Li id Panel 520.74 $20.74 Veni uncture Fee $3.06 $3.06 HIV 1 2 513,26 $13.25 Quantiferon Tb Gold $51.00 $51.00 Wvant. Andrew D. CMP 519.52 $18.52 CBC W /Dill And Plat $17.68 $17.68 Li id Panel 20,74 $20.74 Veni uncture Fee $3.0E S106 HIV 1 2 513.26 513.26 Quantiferon Tb Gold $51.00 51.00 Total Charges $9,756.36 Total Payments Balance Due $0.00 $9,756.36 Please write invoice number on payment check. Our Federal Employer Identification Number is 35- 2079797 INVOICE F o Public Safety Medical Services 324 E. New York Street E Suite 300 x Indianapolis, IN 46204 C Carmel Fire Department I CARMEFD 2 Civic Square Terms Carmel, IN 46032 Invoice Date 09/03/2010 Invoice 00 -13561 Date Employee Description Amount Balance Due Muscle Strength Endurance $26.52 $26.52 Vital Si ns HT WT BP P R $0.00 $0.00 Vision Titmus $26.52 $26.52 PFT W/Interp $33.66 $33.66 Audiometry 14.28 $14,28 ECG W/ Inter 20.40 $20.4 0 Urinalysis Dipstick $3.06 $3.06 Bladder Cancer Screen $45.90 $45.90 Young, Kevin M. Comprehensive Physical 99.96 $99.96 OnMed Program 0 0.00 H i r ofi tion Respirator/Medical Review $16.32 $16.32 Treadmill PFE $156.00 $156.00 BIA Bio -Elec im ed Anal 14.28 $14.28 Waist/Hi Ratio $3.06 $3.06 Flexibility Check $10.20 10.20 Muscle Strength Endurance $26.52 $26.52 Vital Signs HT WT BP P R $0.00 $0.00 Vision Titmus 26.52 $26.52 PFT W /Inter 3 33.66 Audiometry 14.28 ECG W/ Inter 20.40 U rinalysis t Bladder Cancer Screen $45.90 Total Charges $17,072.56 Total Payments Balance Due $0.00 $17,072.56 Please write invoice number on payment check. Balance due 15 days from invoice Our Federal Employer Identification Number is 35- 2079797 date I INVOICE 0 Public Safety Medical Services 324 E. New York Street E Suite 300 W Indianapolis, IN 46204 e Carmel Fire Department 1 CARMEFD t 2 Civic Square Terms Carmel, IN 46032 Invoice Date 08/25/2010 m Invoice 00 -13513 Date Employee Description Amount Balance Due Flexibility Check $10.20 $10.20 Waist/Hi Ratio $3.06 $3.06 Muscle Strength Endurance $26.52 $26.52 BIA Bio -Eiec Im ed Anal 14.28 $14.28 Vital Si ns HT WT BP P R $0.00 $0.00 Vision Titmus $26.52 $26.52 PFT W/Interp $33.66 $33.66 Audiometry 14.28 $14.28 ECG W/ Interp $20.40 $20.4 0 Urinal sis Di stick $3. 06 $3.06 B la d der an er Screen $45. $45. Webb, Gregory A. Com rehensive Physical $99.96 $99.96 QnMed Program $0.00 $0.00 Respirator/Medical Review $16.32 $16.32 Health Risk Appraisal Motivation 0.00 $0.00 Treadmill (PFE 156.00 $156.00 Flexibility Check $10.20 $10.2 0 Waist/Hi Ratio $3.06 $3.06 Muscle Strength Endurance $26.52 $26.52 BIA Bio -Eiec Im ed Anal 14.28 $14.28 Vital Signs HT WT BP P R 10.00 0.00 Vision Titmus $26.52 $26.52 PFT W/Intero $33.66 3. Audiometry $1428 $14.28 ECG W/ Interp $20.40 $20.40 Urinalysis Dipstick $3.06 $3.06 Bladder Cancer Screen $45.90 145.90 Workman, William J. Comprehensive Physical $99.96 $99.96 QnMed Program $0.00 0.00 Res irator /Medical Review 16.32 16.32 Health Risk A raisal Motivation 0.00 0.00 Treadmill PFE F $156.00 156.00 Flexibility Check 10.20 10.20 Waist/Hi Ratio 3.06 Uo6 Muscle Stren th Endur 2 .52 $26.52 BIA (Bic-Eiec Im ed Anal $14.28 $14.28 Vital Signs HT WT BP P R $0.00 $0.00 Vision Titmus $26.52 $26.52 PFT W/Interp $33.66 $33.66 Audiornetry $14.28 $14.28 ECG W/ Int.rp $20.40 $20.40 Urinal sis Dipstick $3.06 $3.06 Bladder Cancer Screen 45.90 45.90 Total Charges $23,293.72 Total Payments Balance Due $0.00 $23,293.72 Please write invoice number on payment check. Balance due 15 days from invoice date INVOICE 0 Public Safety Medical Services 324 E. New York Street E Suite 300 LY Indianapolis, IN 46204 C Carmel Fire Department I CARMEFD 2 Civic Square Terms Carmel, IN 46032 Invoice Date 09109120'10 100 Invoice 00 -13600 Date Employee Description Amount Balance Due PFT W/Interp $33.66 $33.66 Audiometry 14.28 $14.28 DCG W/ Inter 20.40 $20.4 0 Urinalysis Dipstick $3.06 $3,06 Bladder Cancer Screen $45.90 $45.90 LIG3/1 01 Reppert, Ian T. Repeat Chest X -Ray 0.00 0.00 Total Charges $16,602.86 Total Payments Balance Due $0.00 $16,602.86 Please write invoice number on payment check. Our Federal Employer Identification Number is 35- 2079797 INVOICE 0 Public Safety Medical Services 324 E. New York. Street Suite 300 a� Indianapolis, IN 46204 C Carmel Fire Department 1 CARMEFD t 2 Civic Square Terms Carmel, IN 46032 Invoice Date 0911412010 m Invoice 00 -13647 Date Employee Description Amount Balance Due Flexibility Check $10.20 $10.20 Muscle Stren th Endurance $26.52 $26.52 Vitai Signs HT WT BP P R $0.00 $0.00 T' $26.52 PFT W/Interp $33.66 $33.66 Audiometry $14.28 $14.28 ECG W/ Intern $20.40 $20.40 Urinalysis Dipstick $3.06 $3,06 Bladder Cancer Screen $45.90 45.90 Starr. Gregory A. Com rehensive $99.96 $99.96 Hemoccult $0.00 $0.00 OnMed Program $0.00 $0.00 Health Risk Appraisal Motivation 0.00 $0.00 Res iratorlMedical Review $16.32 $16.32 Treadmill (PFE) $156.00 $156.00 BIA (Bio-Elec Imped Anal 14 $14.28 Waist/Hi Ratio $3.06 $3.06 Flexibility Check $10.20 $10.20 Muscle Strength Endurance $26.52 $26.52 Vital Signs HT WT BP P R $0.00 $0.00 Vision Titmus $26.52 $26.52 PFT W/Interp $33.66 $33.66 Audiometry 14.28 $14.28 ECG W/ Interp $20.40 $20.4 0 Urinalysis Dipstick $3.06 $3.06 Bladder Cancer Screen $45.90 $45.90 Youm, Alan R. Com rehensive Physical $99.96 $99.96 O nMed Program $0.00 $0.00 Health Risk Appraisal Motivation $0.00 $0.00 Respirator/Medical Review $16.32 $16.32 Treadmill (PFE) $156.00 $156.00 BIA Bio -Elec Im ed Anal 14.2$ $14.28 WaIsUft Ratio 3.06 3.06 Flexibility Check $10.20 $10.2 0 Muscle Strength Endurance $26.52 $26.52 Vital Signs HT WT BP P R 0.00 $0.00 Vision Titmus 26.52 26.52 PFT W /Inter 33.66 33.66 Audiometry 14.28 14.28 ECG In 2 .4 .4 Urinalysis Dipstick $3.06 $3.06 Bladder Cancer Screen $45.90 $45.90 09/10/10 Ellison. Christopher M. Chest PA/LAT $61.20 $61.20 Total Charges $5,267.44 Total Payments Balance Due $0.00 $5,267.44 Please write invoice number on payment check. INVOICE o Public Safety Medical Services 324 E. New York Street E Suite 300 IY Indianapolis, IN 46204 C Carmel Fire Department 1 CARMEFD 2 Civic Square Terms Carmel, IN 46032 Invoice Date 09114/2010 M Invoice 00 -13647 Date Employee Description Amount Balance Due 09107/10 Cromfich Mark A. Comprehensive Physical 99.96 $99.96 Hemoccult $0.00 $0.00 OnMed Program 0.00 $0.00 Health Risk Appraisal Motivation 0.00 $0.00 Respirator/Medical Review $16.32 $16.32 Treadmill (PFE) $156.00 $156.00 BIA Bio -Elec Im ed Anal 14.28 $14.2B Waist/Hi Ratio $3.06 $3.06 Flexibility Check $10.20 $10.201 Vital Si ns HT WT BP P R $0.00 $G.QO V sion T' u 2 2 $26.52 PFT W/Interp $33.66 $33.66 Audiometry 14.28 $14.28 ECG W/ Interp $20.40 $20.4 0 Urinal sis Dipstick $3.06 $3.06 Bladder Cancer Screen $45.90 $45,90 Gehlbach. Marc A. Comprehensive Physical $99.96 99.96 OnMed Program $0.00 $0.00 Health Risk Appraisal Motivation 0.00 $0.00 Respirator/Medical Review $16.32 $16.32 Treadmill (PFE) $156.00 $156.00 BIA Bio -Ele Im ed Anal 14.28 $14.2 Waist/Hip Ratio $3.06 Flexibility Check $10.20 $10.20 Muscle Strength Endurance $26.52 1 $26.52 Vital Signs HT WT BP P R $0.00 $0.00 Vision Titmus $26.52 $26.52 PFT W/Interp $33.66 $33.66 Audiometry 14.28 14.28 ECG W/ Interp $20.40 $20.40 Urinalysis Dipstick $3,06 $3.06 Bladder Cancer Screen $45.90 45.90 Giles William G. Comprehensive Physical $99.96 $99.96 OnMed Pro ram $0.00 $0.00 H ealth i k Appraisal f Motivation Respirator/Medical Review $16.32 $16.32 Treadmill (PFE) $156.00 $156.00 BIA Bio -Elec im ed Anal $14.28 $14.28 Waist/Hi Ratio $3.06 $3.06 Flexibility Check $10.20 $10.20 Muscle Strength Endurance 26.52 $26.52 Vital Signs HT WT BP P R 10.00 $0.00 Vision Titmus 26.52 $26.52 PFT W/Interp 33.66 $33.66 Audiomet 14.28 $14.281 ECG W1 Intern $20.40 20.40 INVOICE o Public Safety Medical Services 324 E. New York Street E Suite 300 Q W Indianapolis, IN 46204 C Carmel Fire Department CARMEFQ 2 Civic Square Terms Carmel, IN 46032 Invoice Date 09!1412010 m Invoice 00 -13647 Date Employee Description Amount Balance Due Urinalysis Di stick $3.06 $3.06 Bladder Cancer Screen 45.90 $45.90 Hensley, Robert P. Urinal is Di stick $3-06 $3.06 Bladder Cancer Screen $45.9 Comprehensive Physical $99.96 $99.96 OnMed Program $0.00 $0.00 Health Risk Appraisal (Motivation) $0.00 $0.00 Respirator/Medical Review $16.32 $16.32 Treadmill PFE 156.00 $156.00 BIA Bio -Elec Im ed Anal 14.28 $14.28 Waist/Hi Ratio $3.06 $3.06 Flexibilitv Check $10.20 $10.20 Muscle Strength Endurance $26.52 $26.52 Vital Skins HT WT BP P R $0.00 $0.00 Vision Titmus $26.52 $26.52 PF W nterp $33.66 $33.66 Audiometry $14.28 $14.28 ECG W1 Interp $20.40 $20.40 Hughes, Chad L. Comprehensive Physical $99.96 $99,96 OnMed Program $0.00 $0.00 Health Risk Appraisal Motivation 0.00 $0.00 Respirator/Medical Review $16,32 $16.32 Treadmill (PFE) $156.00 $156.001 BIA Bio -Elec Im ed Anal 14.28 $14.28 Waist/Hi Ratio $3.06 $3.06 Flexibility Check $10.20 $10.20 Muscle Strencith Endurance 26.52 $26.52 V T T UP P R $0.00 $0.0 Vision Titmus t$33.66 $26.52 PFT Wllnter $33.66 Audiometr $14.28 ECG W/ Inter $20.40 Urinal sis Di stick 3.06 Bladder Cancer Screen $45.90 $45.90 Keaton Anthony R. Comprehensive Physical $99.96 $99.96 OnMed Program $0.00 0.00 Health Risk Armraisal Motivation 0.00 $0.00 Res iratorlMedical Review 16.32 $16.32 Treadmill (PFE $156.00 $156.0 IA Bio lec I mped Anal 14 14. Waist/Hi Ratio $3.06 $3.06 Flexibility Check $10.20 $10.20 Muscle Strength Endurance $26.52 $26.52 Vital Signs HT WT BP P R $0.00 $0.00 Vision Titmus $26.52 26.52 PFT W/Interp $33.66 $33.66 Audiometry 1428 $14,28 INVOICE 0 Public Safety Medical Services 324 E. New York Street E Suite 300 0 a� Indianapolis, IN 46204 G Carmel Fire Department 1 CARMEFD 2 Civic Square Terms Carmel, IN 46032 Invoice Date 0911412010 m Invoice 00 -13647 Date Employee Description Amount Balance Due ECG W/ Interp $20.40 20.40 Urinalysis Dipstick $3.06 $3.06 Bladder Cancer Screen $45.90 $45.9G Kinney, Jared N. Comprehensive Physical $99.96 $99.96 OnMed Program $0.00 $0.00 Health Risk Appraisal Motivation 0.00 $0.00 Respirator/Medical Review 15.32 $16.32 Treadmill (PFE) $156.00 S156,0 0 BIA Bio -Elec Im ed Anal 14.28 $14.28 Waist/Hi Ratio $3.06 $3.06 Flexibility k $10.20 $1 Muscle Strength Endurance $26.52 $26.52 Vital Signs HT WT BP P R $0,00 0.00 Vision Titmus $26.52 S26.52 PFT W/Interp $33.66 $33.66 Audiometry 14.28 $14.28 ECG W/ Interp 120.40 $20.4 0 Urinal sis Di stick $3.06 $3.06 Bladder Cancer Screen $45.90 $45.90 CMP 19.52 $19.52 CBC W /Diff And Plat 17.68 $17.68 Lipid Panel $20.74 2074 Ven buncture F Marsh, Michael A. Comprehensive Physical $99.96 $99.96 OnMed Program $0.00 $0.00 Health Risk Appraisal Motivation $0.00 1 $0.00 Respirator/Medical Review $16.32 $16.32 Treadmill (PFE) $156.00 $156.00 BIA Bio -Elec Im ed Anal 14.28 $14.28 Waistil-lip Ratio $3.06 3.06 Flexibility Check $10.20 $10.20 Muscle Stren th Endurance 26.52 $26.52 Vital Si ns HT WT BP P R $0,00 0.00 Vision Titmus 26.52 26.52 P I 33 6 $33.6 Audiometry $14.28 $14.28 ECG W/ Interp $20.40 $20.40 Urinalysis Dipstick $3.06 $3.06 Bladder Cancer Screen $45.90 $45.90 McNab John D. Comprehensive Physical $99.96 $99.96 OnMed Program $0.00 $0.00 Health Risk Appraisal Motivation 0.00 $0.00 Respirator/Medical Review $16.32 $16.32 Treadmill (PFE) $156.00 $156.00 BIA Bio -Elec Im ed Anal 14.28 $14.28 Wais Hi Ratio $3,06 .06 INVOICE t° Public Safety Medical Services 324 E. New York Street Suite 300 W Indianapolis, IN 46204 0 Carmel Fire Department I CARMEFD 2 Civic Square Terms Carmel, IN 46032 Invoice Date 09/0912010 Invoice 00 -13600 Date Employee Description Amount Balance Due 08130!10 Bartrom. Brad A. Comprehensive Physical $99.96 $99.96 OnMed Program $0.00 $0.00 Respirator/Medical Review $16.32 $16.32 Health Risk Appraisal Motivation 0.00 $0.00 Treadmill (PFE) $156.00 $156.00 Flexibility Check $10.20 $10.20 Waist/Hi Ratio $3,06 $3.06 Muscle Strencith Endurance 26.52 $26.52 BIA Bio -Elec Im ed Anal 14.28 $14.28 Vital Signs HT WT BP P R $0.00 $0.00 Vision Ti $26.52 $26.52 PFT W/Interp $33.66 $33.66 Audiornetry $14.28 $14.28 ECG W/ Interp $20.40 520.40 Urinalysis Dipstick $3.06 $3.06 Bladder Cancer Screen $45.90 $45.90 Bowles Orbie H. BIA Bio -Elec Im ed Anal 14.28 $14.28 Chest PA /t_AT $61.20 $61.20 Vital Signs HT WT BP P R $0.00 $0.00 Vision Titmus $26.52 26.52 PFT W/1 nterp $33.66 $33.66 Audiornetry $14.28 $14.28 ECG W/ Inter Interp $2 0,4Q 20.40 Urinalysis Dipstick $3.06 $3.06 Tb Skin Test $7.14 $7.14 Bladder Cancer Screen t16.32 45.90 Com rehensive Physical 99.96 OnMed Program 0.00 Respirator/Medical Review 16.32 Health Risk A raisal Motivation $0.00 Treadmill (PFE) $156.00 $156.0 0 Flexibilitv Check $10.20 $10.2 0 Waist/Hi Ratio $3.06 $3.06 Muscle Stren th Endurance $26.52 $26.52 Br Michael D Comprehensive Physical 9 OnMed Program $0.00 $0.00 Respirator/Medical Review $16.32 $16.32 Health Risk Appraisal Motivation $0.00 $0.00 Treadmill (PFE) $156.00 $156.00 Flexibility Check $10.20 $10.20 Waist/Hi Ratio $3.06 $3.06 Muscle Stren th Endurance 26.52 26.52 BIA Bio -Elec Im ed Anal 14.28 $14.28 Vital Signs HT WT BP P R $0.00 $0.00 Vision Titmus 26.52 $26.52 PFT W/Interl2 $33.66 $33.66 INVOICE W Public Safety Medical Services 324 E. New York Street E Suite 300 W Indianapolis, IN 46204 C Carmel Fire Department 1 CARMEFD t 2 Civic Square Terms Carmel, IN 46032 Invoice Date 09/09/2010 m Invoice 00 -13600 Date Employee Description Amount Balance Due Audiometry 14.28 $14.28 ECG W/ Interp $20.40 $20.401 Urinalysis Dipstick $3.06 $3.06 Bladd Cancer Screen $45.9c) $4 5,90 McNeely, Michael W. Waist /Hi Ratio $3.06 $3.06 Muscle Strength Endurance $26.52 $26.52 BIA Bio -Eiec Im ed Anal 14.28 $14.28 Vital Si ns HT WT BP P R $0.00 $0.00 Vision Titmus 26.52 $26.52 PFT W/Interp 33.66 $33.66 Audiomet 14.28 $14.28 ECG W/ Interp $20.40 $20.4 0 Urinalysis Dipstick J3.06 $3.061 Bladder Cancer Screen $45.90 $45.90 Com rehensive Physical $99.96 $99.96 Respirator/Medical Review $16.32 $16.32 Health Risk Appraisal Motivation $0.00 $0.00 Treadmill (PFE) $156.00 $156.00 Flexibility Check $10.20 $10.20 Moriarty, John F. Comprehensive Physical $99.96 $99.96 OnMed Pro ram $0.00 $0.00 Respirator/Medical Review $16.32 $16.32 Health Risk Appraisal Motivation $0.00 0.00 Treadmill (PFE) $156.00 $156.00 Flexibility Check $10.20 1020 WaisUHl Ratio $3.06 $3.06 Musc r 2 BIA Bio -Eiec Im ed Anal $14.28 $14.28 Vital Signs HT WT BP P R $0.00 $0.00 Vision Titmus $26.52 $26.52 PFT W/Interp $33.66 $33.66 Audiometry $14.28 $14.28 ECG W/ Interp $20.40 20.40 Urinalysis Dipstick $3.06 $3.06 Bladder Cancer Screen $45.90 $45.90 Plumer, Charles J. Comprehensive Physical $99.96 99.96 OnMed Program $0.00 $0.00 Res it for Medical Review $16.32 $16.32 Health Risk Apl2raisal f Motivati Treadmill (PFE) $156.00 $156.00 Flexibility Check $10.20 $10.20 WaisUHl Ratio $3.06 $3.06 Muscle Strength Endurance $26.52 $26.52 BIA Bio -Eiec im ed Anal 14.28 1428 Chest PAIAT $61.20 $61.20 Vital Signs HT WT BP P R 0.00 $0.00 INVOICE 0 Public Safety Medical Services 324 E. New York Street E Suite 300 a) it Indianapolis, IN 46204 G Carmel Fire Department I CARMEFD t" 2 Civic Square Terms Carmel, IN 46032 Invoice Date 09/09/2010 m Invoice 00 -13600 Date Employee Description Amount Balance Due Vision Titmus $26.52 $26.52 PFT W/Interp $33.66 $33.66 Audiornetry $14.28 $14.28 ECG W/ Interp $20.40 $20.40 Urinalysis Dipstick $3.06 3.06 Bladder Cancer Screen $45.90 $45.90 Ray. Lucas M. Comprehensive Physical $99.96 $99.96 OnMed Program SO.00 $0.00 Res irator /Medical Review $16.32 S16.321 Health Risk A raisal Motivation 0.00 $O.DO Treadmill (PFE) $156.00 $1 56OQ Flexibilitv Check $10.20 $10.20 Waist/Hi Ratio 3.06 $3.06 Muscle Strength Endurance $26.52 $26.52 BIA Bio -Elec Im ed Anal 1428 $14.28 Vital Signs HT WT BP P R $0.00 $0.00 Vision Titmus $26.52 $26.52 PFT W/Interp $33.66 $33.66 Audiometry 14.28 $14.28 ECG Wl Inter 20.40 $20.40 Urinalysis Dipstick $3.06 $3.06 Bladder Cancer Screen $45.90 $45.90 Reyn olds, wn J. CornDrehensive Physical .9 OnMed Program $0.00 $0.00 Respirator/Medical Review $16.32 $16.32 Health Risk Appraisal Motivation 0.00 $0.00 Treadmill- (PFE $156.00 $156.00 Flexibility Check $10.20 S10.201 Waist/Hi Ratio $3.06 $3.06 Muscle Strength Endurance $26.52 $26.52 BIA Bio -Elec Im ed Anal $14.28 $14.28 Chest PA/LAT $61.20 $61.2 0 Vital Si ns HT WT BP P R $0,00 $0.00 Vision Titmus $26.52 $26.52 PFT Wllntgr $33.66 S33.66 Audiornetry $14.28 $14.28 ECG W/ Interp $20.40 $20.40 Urinalysis Dipstick $3.06 3.06 Bladder Cancer Screen $45.90 $45.90 Toney, James D. Comprehensive Physical $99.96 $99.96 OnMed Program $0.00 $0.00 Res irator /Medical Review $16.32 $16.32 Health Risk Appraisal Motivation 0.00 $0.00 Treadmill (PFE $156.00 $156.00 Flexibility Check $10.20 $10.2 0 Waist /Hi Ratio $3.06 3.06 INVOICE 0 Public Safety Medical Services r 324 E. New York Street E Suite 300 a) W Indianapolis, IN 46204 C Carmel Fire Department 1 CARMEFD 2 Civic Square Terms Carmel, IN 46032 Invoice Date 09/09/2010 m Invoice 00 -13600 Date Employee Description Amount Balance Due Muscle Strencith Endurance $26.52 $26.52 BIA Bio -Elec Im ed Anal 14.28 $14.28 Vital Si ns HT WT BP P R $0.00 $0.00 Vision Titmus $26.52 $26.52 PFT W/Interp $33.66 $33.66 Audiometry $14.28 1 $14.28 ECG W/ Interp $20.40 20.40 Urinalysis Dipstick $3.06 $3.06 Bladder Cancer Screen $45.90 $45.90 Vallone, Frank Waist/Hi Ratio $3,06 $3.06 Muscle Stren th Endurance $26.52 $26.521 BIA Bio -Elec Im ed Anal 14.28 $14.28 Vital Si ns HT WT BP P R SO.00 $0.00 Vision Titmus $26.52 $26.52 PFT W /Inter 3.66 $33.66 Audiometry 14. 14 ECG W/ Interp $20.40 $20.40 Urinalysis Dipstick $3.06 $3.06 Bladder Cancer Screen $45.90 $45.90 Comprehensive Physical $99,96 $99.96 OnMed Program $0.00 $0.00 Respirator/Medical Review $16.32 $16.321 Health Risk Appraisal Motivation 0.00 $0.00 Treadmill (PFE) $156.00 156.00 Flexibility Check $10.20 $10.2 0 Weaver Viral L. om rehensive Physical $99.96 $99.96 OnMed Pro ram $0.00 $0.00 Respiralgr/M Review $1632 1 Health Risk Appraisal Motivation $0.00 $0.00 Treadmill (PFE) $156.00 $156.00 Flexibilitv Check $10.20 $10.20 Waist/Hi Ratio $3.06 $3.06 Muscle Strength Endurance $26.52 26.52 BIA Bio -Elec Im ed Anal 14.28 $14.28 Vital Signs HT WT BP P R $0.00 $0.00 Vision Titmus $26.52 $26.52 PFT W/Interp $33.66 $33.66 Audiametry $14.28 $14.28 ECG W/ Interp $20.40 S20.4 0 U in tick Bladder Cancer Screen $45.90 $45.90 Workman, William J. CMP $19.52 $19.52 CBC W /Dill And Rat $17.68 $17,68 Li id Panel $20.74 $20.74 Veni uncture Fee $3.06 $3.06 HIV 1 2 $13.26 1326 PSA $35.70 $35.70 INVOICE t0 Public Safety Medical Services 324 E. New York Street E Suite 300 m W Indianapolis, IN 48204 C Carmel Fire Department! CARMEFD Terms 2 Civic Square Invoice Date 09/0912010 m Carmel, IN 46032 Invoice 00 -13800 Date Employee Description Amount Balance Due Young Andrew S. Comprehensive Physical $99.96 $99.96 OnMed Program $0.00 $0.00 Respirator/Medical Review $16.32 $16.32 Health Risk Appraisal Motivation 0.00 $0.00 Treadmill (PFE) $156.00 S156.00 Flexibility Check $10.20 $10.2 0 Waist/Hi Ratio 3.06 $3.06 Muscle Strencith Endurance $26.52 $26.52 BIA Bic -Elec Im ed Anal 14.28 $14.28 Vital Signs HT WT BP P R $0.00 .00 Vision 2 PFT W/Interp $33.66 $33.66 Audiometry $14.28 $14.28 ECG W/ Interp $20.40 $20.40 Urinalysis Dipstick $3.06 $3.06 Bladder Cancer Screen $45.90 $45.90 08131/10 Allen Brad A. Comprehensive Physical $99.96 $99.96 OnMed Program $0.00 $0.00 Respirator/Medical Review $16.32 $16.32 Health Risk Appraisal Motivation 0.00 $0.0o Treadmill.- PFE 156.00 S156.00 Flexibility Check 110.20 $10.20 Waist/Hip Ratio $3 6 Muscle Stren th Endurance $26.52 $26.52 BIA Bic -Elec Im ed Anal $14.28 $14.28 Chest PAILAT $61.20 $61.20 Vital Signs HT WT BP P R $0.00 $0.00 Vision Titmus $26.52 $26.52 PFT W/Interp $33.66 $33.66 Audiometry $14.28 $14.28 ECG W1 Inter 20.40 20.40 Urinalysis Dipstick $3.06 $3.06 Bladder Cancer Screen $45.90 $45.90 Crane Barry L. Hemoc It 00 $0.00 Treadmill (PFE) $1 Flexibility Check $10.20 $10.20 WaisUHi Ratio $3.06 $3.06 Muscle Strength Endurance 26.52 1 $26.52 BIA Bio -Elec Im ed Anal 14.28 $14.28 Chest PA /LAT $61.20 $61,2 0 Vital Signs HT WT BP P R 0.00 0.00 Vision Titmus $26.52 26.52 PFT W/Intero $33.66 $33.66 Audiometr 14.28 $14.28 ECG W/ interp $20.40 $20.40 Urinalysis Dipstick $3.06 $3.06 INVOICE 0 Public Safety Medical Services 324 E. New York Street E Suite 300 d W Indianapolis, IN 46204 c Carmel Fire Department! CARMEFD 2 Civic Square Terms Carmel, IN 46032 invoice Date 09!0912010 Invoice 00 -13600 Date Employee Description Amount Balance Due Bladder Cancer Screen $45.90 $45.90 Corniprehensive Physical $99. $99.96 OnMed Program 10.00 $0.00 e it t M i I Review 1 1 Health Risk Appraisal Motivation $0.00 $0.00 Fisher. Gary L Comprehensive Physical $99.96 $99.96 OnMed Pro ram $0,00 0.00 Respirator/Medical Review $16.32 $16.32 Health Risk Appraisal Motivation 0.00 $0.00 Treadmill (PFE $156.00 $156.00 Flexibilitv Check $10.20 $10.2 0 Waist/Hi Ratio $3.06 $3.061 Muscle Stren th Endurance $26.52 $26.52 BIA Bio -Elec Im ed Anal 14.28 S14.28 Chest PA/i_AT $61.20 $61.20 VitaJ Sions -HT WT BP PR Vision Titmus $26.52 $26.52 PFT WlInterp $33.66 $33.66 Audiometry $14.28 $14.28 ECG W/ Enter $20.40 $20.40 Urinal sis Dipstick 3.06 3.06 Bladder Cancer Screen $45.90 $45,90 Foster. James P. Comprehensive Ph sica! 99.96 99.96 OnMed Program 0.00 0.00 Respirator/Medical Review 16.32 16.32 Health Risk A raisal Motivation 0.00 0.00 Treadmill PFE 156.0Q 156.00 Flexibility Check 1 Waist/Hi Ratio $3.06 $3.06 Muscle Strength Endurance $26.52 $26.52 BIA Bio -Elec Im ed Anal 14.28 $14.28 Vital Signs HT WT BP P R 0.00 $0.00 Vision Titmus $26.52 $26.521 PFT W/Interp $33.66 $33.66 Audiometry 14.28 $14.28 ECG W! Inter 2040 $20.4 0 Urinalysis Di stick $3.06 $3.06 Bladder Cancer Screen $45.90 45.90 Haus Joshua S. Com rehensive Physical $99,96 $99.961 On Med Pr comm Respirator/Medical Review $16.32 $16.32 Health Risk Appraisal Motivation $0.00 $0.00 Treadmill (PFE) $156.00 $156.00 Flexibilitv Check $10.20 $10.20 Waist/Hi Ratio $3.06 S3.061 Muscle StrencIth Endurance $26.52 26.52 SIA Bio -Elec Im ed Anal $14.28 $14.28 INVOICE 0 Public Safety Medical Services 324 E. New York Street E Suite 300 W Indianapolis, IN 46204 C Carmel Fire Department I CARMEFD 2 Civic Square Terms Invoice Date 0910912010 Carmel, IN 46032 0 Invoice 00 -13600 Date Employee Description Amount Balance Due Vital Signs HT WT BP P R $0.00 $0.00 Vision Titmus $26.52 $26.52 PFT W/Interp $33.66 $33.66 Audiornetry $14,28 14.28 ECG W/ Interp $20.40 20.40 Urinalysis Dipstick $3,06 $3.06 Bladder Cancer Screen 145.90 $45.90 Holubik Steven W. Com rehensive Physical $99.96 $99.96 OnMed Program $0.00 SO.001 Res irator /Medical Review $16. $16.32 H ealth Risk Appraisal (Motivation 0.00 Treadmill (PFE $156.00 $156.00 Flexibility Check $10.20 $10.20 Waist/Hi Ratio $3.06 $3.06 Muscle Strength Endurance $26.52 $26.52 BIA Bio -Elec Im ed Anal 14.28 $14.28 Vital Signs HT WT BP P R $0.00 0.00 Vision Titmus $26.52 $26.52 PFT W/Interp $33.66 $33.66 Audiornetry $14.28 $14.28 ECG W/ Inter 20.40 $20.40 Urinalysis Di stick $3,06 $3.06 Bladder Cancer Screen $45.90 $4 5.90 Kehl, William D. Comprehensive Physical $99.96 $99.96 OnMed Program $0.00 $0.00 Respirator/Medical Review $16.32 $16.32 Health Risk Appraisal Motivation 0.00 $0.00 Treadmill (PFE $156.00 $156.00 Flexibility Check $10.20 $10.2 0 Waist/Hi Ratio $3.06 $3.061 Muscle Strength Endurance $26,52 $26.52 Hemoccult $0.00 $0.00 Vital Si ns HT WT BP P R $0.00 $0.00 Vision Titrnu5 $26.52 $26.52 P In 3.6 Audiometry $14.28 $14.28 ECG W/ Interp $20.40 $20.40 Urinal sis Dipstick $3.06 $3.06 Bladder Cancer Screen 45.90 $45.90 Reppert Ian T. Comprehensive Physical $99.96 99.96 OnMed Program $0.00 so.0ol Respirator/Medical Review $16.32 $16.32 Health Risk Appraisal Motivation 0.00 $0.00 Treadmill (PFE) $156.00 $156,00 Flexibility Check $10.20 $10.2 0 Waist/Hi Ratio $3.06 $3.06 INVOICE 0 Public Safety Medical Services 324 E. New York Street E Suite 300 aV M Indianapolis, IN 46204 o Carmel Fire Department I CARMEFD 2 Civic Square Terms Carmel, IN 46032 Invoice Date 09/09/2010 m Invoice 00 -13600 Date Employee Description Amount Balance Due Muscle Stren th Endurance $26.52 $26.52 BIA Bio -Elec Imped Anal 14.28 $14.28 Chest PA/LAT $61.20 $61.2 0 Vital Si n -HT WTBPPR Vision Titmus $26.52 $26.52 PFT W/Interp $33.66 $33.66 Audiometry 14.28 $14.28 ECG W1 Interp $20.40 20.40 Urinalysis Dipstick $3.06 $3.06 Bladder Cancer Screen $45.90 $45.90 Rohr. Christopher M. Comprehensive Physical $99.96 $99.96 OnMed Pro ram $0.00 $0.00 Respirator/Medical Review $16.32 16.32 Health Risk Appraisal Motivation 0.00 0.00 Treadmill (PFE) $156.00 $156.00 Flexibility heck $10.20 $1 0,20 WaistlHi Ratio $3.06 $3.06 Muscle Strength Endurance $26.52 $26.52 BIA Bio -Elec Im ed Anal 14.28 $14.28 Vital Signs HT WT BP P R $0.00 0.00 Vision Titmus $26.52 $26.52 PFT W/Interip $33.66 $33,66 Audiometry $14.28 $14.28 ECG W/ Interp $20.40 $2G.40 Urinalysis Di stick $3.06 $3.06 Bladder Cancer Screen $45.90 $45-90 Steele Jeffrey A. Com rehensive Physical $99.96 $99.96 OnMed Prggram $0.00 Respirator/Medical Review $16.32 $16.32 Health Risk Appraisal Motivation $0.00 $0.00 Treadmill (PFE $156.00 $156.00 Flexibility Check $10.20 $10.20 Waist/Hi Ratio 3.06 $3.06 Muscle Strength Endurance $26.52 $26.52 BIA Bio -Elec Im ed Anal 14.28 $14.28 Vital Signs HT WT BP P R 0.00 $0.00 Vision Titmus 26.52 $26.52 PFT W/Intern $33.66 $33.66 Audiometry 14.28 $14.28 ECG W Inter 4 Urinalysis Dipstick $3.06 $3.06 Bladder Cancer Screen $45.90 $45.90 VanVoorst. Robert J. Comprehensive Physical $99.96 $99.95 OnMed Program 0.00 $0.00 Respirator/Medical Review $16.32 $16.32 Health Risk Appraisal Motivation 0.00 $0.00 Hemoccult so.00 $0,0d INVOICE oo Public Safety Medical Services 324 E. New York Street Suite 300 W Indianapolis, IN 46204 o Carmel Fire Department I CARMEFD 2 Civic Square Terms Carmel, IN 46032 Invoice Date 09/09/2010 Invoice 00 -13600 Date Employee Description Amount Balance Due Treadmill (PFE $156.00 $156.00 Flexibility Check $10.20 $10.2 0 Waist/Hi Ratio $3.06 $3.06 Muscle Strength Endurance $26.52 $26.52 BIA Bio -Elec Im ed Anal 14.28 $14.28 Vital Signs HT WT BP P R $0.00 0.00 Vision Titmus $26.52 $26.52 PI=T W /Inter 33.66 $33,66 Audiometry 14.28 $14.28 ECG W/ Inter 20.40 $20.40 Ur inalysis Dipstick $3. Bladder Cancer Screen $45.90 $45.90 Chest PAILAT 61.20 $61.20 CDL Form $25.00 $25.0 0 Woodburn, Scott E. Comprehensive Physical $99.96 $99.96 OnMed Program 0.00 $0.00 Respirator/Medical Review $16,32 $16.32 Health Risk Appraisal Motivation 0.00 $0.00 Treadmill (PFE) $156.00 $156.DO Flexibilitv Check $10.20 $10.20 Waist /Hi Ratio $3.06 $3,06 Muscle Stren th Endurance $26. $26.52 EII i ed A riaM $14.2Q $14.2 Vital Signs HT WT BP P R $0.00 $0.00 Vision Titmus $26.52 $26.52 PFT W/Interp $33.66 $33.66 Audiometry M45.90 $1428 ECG W1 Inter 20.40 Urinal sis Dipstick 3.06 Bladder Cancer Screen 45.90 09101/10 Cox. Justin M. Com rehensive Ph sical 99.96 OnMed Program 0.00 $0.00 Health Risk Appraisal Motivation 0.00 $0.00 Re irator /Medical Review $16.32 $16.32 Treadmill PFE $156.00 $156.00 BIA Bio -Elec Im ed Anal $14.28 $14.28 WaisUHJ2 Ratio $3.06 $3.06 Flexibilitv Check $10.20 $10,20 Muscle Strength Endurance $26.52 $26.52 Vital Signs HT WT BP P R $0.00 $0.00 Vision Titmus $25.52 $26.52 PFT W/Interp $33.66 $33.66 Audiometry $14.28 $14.28 ECG Wl Interp 1 $20.40 $20.40 Urinalysis Dipstick $3,06 $3.06 Bladder Cancer Screen $45.90 45.90 INVOICE o Public Safety Medical Services 324 E. New York Street E Suite 300 W Indianapolis, IN 46204 G Carmel Fire Department 1 CARMEFD 2 Civic Square Terms Carmel, IN 46032 Invoice Date 0910912010 00 Invoice 00 -13600 Date Employee Description Amount Balance Due Cummins Frank C. Com rehensive Physical $99.96 $99.96 OnMed Program $0.00 $0.00 Health Risk A raisal Motivation 0.00 $0.0 f Review $16.32 $16.32 Treadmill (PFE) $156.00 $156.00 BIA Bio -Elec im ed Anal $14.28 $14.28 Waist/Hi Ratio $3.06 $3.06 Flexibility Check $10.20 $10.20 Muscle Strength Endurance $26,52 $26.52 Vital Signs HT WT BP P R 0.00 $0.00 Vision Titmus $26.52 $26.52 PFT W /Inter 33.66 $33.66 Audiornetry $14.28 $14.28 ECG W/ Interp $20.40 $20.40 Urinalysis Dipstick $3.06 $3.0 Bladde Cancer Screen $45.90 4 Ellison, Christopher M. Comprehensive Physical $99.96 $99.96 OnMed Program $0.00 $0.00 Health Risk Appraisal Motivation $0.00 $0.00 Respirator/Medical Review $16.32 $16.32 Treadmill (PFE) $156.00 $156.00 BIA Bio -Elec Im ed Anal 14.28 $14.28 Waist/Hi Ratio $3.06 3.06 Flexibility Check $10.20 $10.20 Muscle Strength Endurance $26.52 $26.52 Vital Si ns HT WT BP P R $0.00 $0.00 Vision Titmus $26.52 $26.52 PFT $33.6 Audiometry $14.28 $1428 ECG W/ Interp $20.40 $20.40 Urinalysis Dipstick $3.06 $3.06 Bladder Cancer Screen $45.90 $45.90 Freer. Keith T. Comprehensive Physical $99.96 $99.96 OnMed Program $0.00 $0.00 Health Risk Appraisal Motivation 0.00 $0.00 Respirator/Medical Review $16.32 $16.32 Treadmill PFE 156.00 $156.00 BIA Bio -Elec Im ed Anal 14.28 $14.28 Waist/Hi Ratio $3.06 3.06 Flex h $1 0.20 $10.201 Muscle Strength Endurance $26.52 $26.52 Vital Signs HT WT BP P R $0.00 $0.00 Vision Titmus $26.52 $26.52 PFT W/Interp $33.66 $33.66 Audiometry 1428 14.28 ECG W/ Interg $20.40 120.40 Urinalysis Dipstick 3.06 $3.06 INVOICE o Public Safety Medical Services 324 E. New York Street E Suite 300 d Indianapolis, IN 46204 o Carmel Fire Department I CARMEFD 2 Civic Square Terms Carmel, IN 46032 Invoice Date 0910912010 m Invoice 00 -13600 Date Employee Description Amount Balance Due Bladder Cancer Screen $45.90 $45.90 Frost, Bruce S. Comprehensive Physical $99.96 $99.96 OnMed Pro ram 0.00 10.00 Health Risk Appraisal Motivation 0.00 $0.00 Res irator /Medical Review $16.32 $16.32 Treadmill (PFE) $156.00 156.00 BIA Bio -Elec Im ed Anal 14.28 $14.28 WaisUHip Ratio 3.06 $3.06 Flexibility Check $10.20 $10.20 Muscle Strength Endurance 26.52 26.52 V' f n -HT VVT UP P Vision Titmus $26.52 $26.52 PFT W /Inter 33.66 33.66 Audiometr 14.28 14.28 ECG W/ Inter 20.40 20.40 Urinal ysis Dipstick 3.06 3.06 Bladder Cancer Screen 45.90 45.90 Harrington, Adam C. Comprehensive Physical 99.96 99.96 OnMed Program $0.00 $0.00 Health Risk Aporaisal Motivation 0.00 $0.00 Res irator /Medical Review $16.32 $16.32 Treadmill (PFE) $156.00 $156.00 IA (Bic- I m e n aly) $14.28 $1 4.28 Waist/Hi Ratio $3.06 $3.06 Flexibility Check $10.20 $10.20 Muscle Strength Endurance $26.52 $26.52 Vital Signs HT WT BP P R 0.00 $0.00 Vision Titmus 26.52 $26.52 PFT W/Interp 33.66 $33.66 Audiornetry $14.28 $14.28 ECG W/ Intern $20.40 $20,40 Urinalysis Di stick $3.06 $3.06 Bladder Cancer Screen $45.90 $45.90 Haymaker Samuel K. Com rehensive Phy§ical $99.96 1 199-96 He oc ult $0.00 OnMed Program $0.00 $0.00 Health Risk Appraisal Motivation $0.00 $0.00 Respirator/Medical Review $16.32 $16.32 Treadmill PFE 156.00 156.00 BIA Bio -Elec Im ed Anal 14.28 14.28 Waist/Hi Ratio 3.06 3.06 Flexibility Check 10.20 10.2D Muscle Stren th Endurance 26.52 $26.52 Vital Signs HT WT BP P R 0.00 $0.00 Vision Titmus I S26.52 26.52 PFT W/Interip $33.66 33.6 INVOICE H Public Safety Medical Services 324 E. New York Street E Suite 300 am W Indianapolis, IN 46204 o Carmel Fire Department 1 CARMEFD 2 Civic Square Terms Carmel, IN 46032 Invoice Date 09I0912010 Invoice 00 -13600 Date Employee Description Amount Balance Due Audiometry 14.28 $14.28 ECG W1 Inter 20.40 $20.40 Urinalysis Dipstick $3.06 $3.06 Canc cre n $4 5.90 Sharp, Adam C. Audiometry $14.28 $14.28 ECG W/ Interp $20.40 $20.40 Urinalysis Dipstick $3.06 $3.06 Bladder Cancer Screen $45.90 $45.90 Comprehensive Physical $99.96 $99.96 OnMed Program $0.00 $0.00 Health Risk Appraisal Motivation 0.00 $0.00 Respirator/Medical Review $16.32 $16.32 Treadmill PFE 156.00 $156.00 BIA Bio -Elec Imped Anal 14.28 $14.28 Waist/Hip Ratio $3.06 $3.06 Flexibility he k $10.20 $1 0.201 Muscle Strength Endurance $26.52 $26.52 Vital Signs HT WT BP P R $0.00 $0.00 Vision Titmus $26.52 $26.52 PFT W/Interp $33.66 $33.66 Small Thomas D. Comprehensive Physical $99.96 $99.96 OnMed Program $0.00 $0.00 Health Risk Appraisal Motivation 0.00 $0.00 Respirator/Medical Review 16.32 $16.32 Treadmill (PFL) $156.00 $156.00 BIA (Bic-Elec Im ed Ana-1 14.28 $14.28 Waist/Hi Ratio 3.06 $3.06 Flexibility h k $10.20 110.2 0 Muscle Strength Endurance $26.52 $26.52 Vital Si ns HT WT BP P R $0.00 $0.00 Vision Titmus $26.52 $26.52 PFT W/Interp $33.66 $33.66 Audiometry 14.28 1428 ECG Wl Interp $20.40 $20.4 0 Urinal sis Dipstick $3.06 $3.06 Bladder Cancer Screen $45.90 $45,90 Thom son. James L. Comprehensive Physical $99.96 $99.96 OnMed Pra ram $0.00 $0.00 Health Risk Apvraisal Motivation .00 $0.00 Respirator/Medical Review $16.32 Treadmill (PFE) $156.00 $156.00 BIA Bio -Elec Im ed Anal $14.28 $14.28 Waist/Hi Ratio $3.06 $3.06 Flexibilitv Check $10.20 $10.20 Muscle Strength Endurance 25.52 26.52 Vital Si ns HT WT BP P R $0.00 $0.00 Vision Titmus $26.52 $26.52 r INVOICE 0 Public Safety Medical Services 324 E. New York Street E Suite 300 W Indianapolis, IN 46204 C Carmel Fire Department I CARMEFD 2 Civic Square Terms Carmel, IN 46032 Invoice Date 08/25/2010 m Invoice 00 -13513 Date Employee Description Amount Balance Due 08/17/10 Brandt Gary D. Comprehensive Physical $99.96 $99.96 OnMed Program $0,00 $0.00 Health Risk Appraisal Motivation 0.00 $0,00 Respirator/Medical Review $16.32 116.32 Treadmill (PFE) $156.00 $156,00 BIA Bio -Elec Im ed Anal 14.28 $14.28 Waist/Hi Ratio $3.06 $3.06 Flexibility Check $10.20 $10.20 Muscle Strength Endurance $26.52 $26,52 Chest PA/LAT $61.20 $61,20 Vit I ins HT WT BP P R 0.00 Vision Titmus $26.52 $26.52 PFT W/Interp $33.66 $33,66 Audiomet 14.28 $14.28 ECG W/ interp $20.40 $20.40 Urinalysis Dipstick $3.06 $3.06 Bladder Cancer Screen $45,90 $45.90 Butts Joseph A. Comprehensive Physical $99.96 $99.96 OnMed Program $0. 00 $0.00 Health Risk Appraisal Motivation 0.00 $0.00 Respirator/Medical Review $16.32 16.32 Treadmill (PFE) $156.00 S156,0 0 BIA (Big Elec ImQed An f 14.8 $14.2 Waist/Hi Ratio $3.06 $3.06 Flexibility Check $10.20 $10.20 Muscle Strength Endurance $26,52 $26.52 Vital Signs HT WT BP P R $0.00 $0,00 Vision Titmus $26.52 $26.52 PFT W/Interp $33,66 $33,66 Audiomet $14.28 $14.28 ECG W/ Interp $20,40 $20.4 0 Urinalysis Dipstick $3,06 $3.06 Bladder Cancer Screen $45.90 $45.90 Butts, Renee L. Comprehensive Physical $99.96 $99.96 OnMed Pro ram $0,00 $000 Health Risk Appraisal Motivation $0.00 $0.00 Respirator/Medical Review $16.32 $16.32 Treadmill (PFE) $156.00 $156 DO BIA Bio -Elec Im ed Anal 1428 $14.28 Waist/Hi Ratio $3,06 $3.06 Flexibility Check $10.20 $10.2 0 Muscle Strength Endurance $26,52 126.52 Vital Signs HT WT BP P R $0.00 $0,00 Vision Titmus $26.52 $26.52 PFT W/Interip $33.66 $33.66 Audiometry 14.28 $14.28 INVOICE 0 Public Safety Medical Services 324 E. New York Street E Suite 300 a) X Indianapolis, IN 46204 o Carmel Fire Department 1 CARMEFD Terms 2 Civic Square Invoice Date 08/25/2010 m Carmel, IN 46032 Invoice 00 -13513 Date Employee Description Amount Balance Due ECG W/ Inter 20.40 $20.40 Urinalysis Dipstick $3.06 1206 Bladder Cancer Screen $45.90 $45.90 ri I r John H. Comprehensive Ph ical $99.96 Hemoccult $0.00 $0.00 OnMed Pro ram $0.00 $0.00 Health Risk Appraisal Motivation $0.00 $0.00 Respirator/Medical Review $16.32 $16.32 Treadmill (PFE $156.00 $156.0 0 BIA Bio -Elec Im ed Anal 14.28 114.28 Waist/Hi Ratio $3.06 $3.06 Flexibility Check $10.20 $10.201 Muscle Strength Endurance $26.52 $26.52 Vital Signs HT WT BP P R $0.00 $0.00 Vision Titmus $26.52 $26.52 PFT W/Interlp $33.66 $33.66 Audiometry $14.28 $14.28 ECG W/ Interp $20.40 $20.40 Urinalysis Dipstick $3.06 $3.06 Bladder Cancer Screen $45.90 $45.90 Deitsch Marc W. Audiomet $14.28 $14.28 ECG W/ Interp $20.40 $20.40 Urinalysis Dipstick $3.06 $3.06 Bladder Cancer Screen $45.90 $45.90 Comprehensive Physical 99.96 $99.96 OnMed Program $0.00 0.00 Health Risk Appraisal Motivation 0.00 $0.00 &spirator/Medical Review $16. $16.32 Treadmill (PFE $156.00 $156.00 BIA Bio -Elec Im ed Anal $14.28 $14.28 Waist/Hi Ratio $3.06 $3.06 Flexibility Check 10.20 $10.2 0 Muscle Strength Endurance $26.52 $26.52 Chest PA/LAT $61.20 $61.2G Vital Signs HT WT BP P R $0.00 $0,00 Vision Titmus $26.52 $26.52 PFT W/Interp $33.66 $33.66 Griffin Timothy M. Comprehensive Physical $99.96 $99.96 O nMed PrograM $0.00 Health Risk A r isal M tiv ti n Respirator/Medical Review $16.32 $16.32 Treadmill (PFE) $156.00 $156.00 BIA Bio -Elec Im ed Anal $14.28 $14.28 WaisUft Ratio $3.06 $3.06 Flexibility Check 10.20 $10.20 Muscle Strength Endurance $26,52 $26.52 Vital Signs HT WT BP P R so.00 10.00 INVOICE t o Public Safety Medical Services 324 E. New York Street E Suite 300 Indianapolis, IN 46204 C Carmel Fire Department 1 CARMEFD 2 Civic Square Terms Carmel, IN 46032 Invoice Date 08/25/2010 m Invoice 00 -13513 Date Employee Description Amount Balance Due Vision Titmus $26.52 $26.52 PFT W/Interp $33.66 $33.66 Audiometry 14.28 $14.28 ECG W/ Interp $20.40 $20.4 0 Urinalysis Dipstick $3.06 3.06 Bladder Cancer Screen $45.90 45.90 Howard Wendell E. Comprehensive Physical $99,96 $99,96 Hemoccult $0.00 0.00 OnMed Pro ram $0,00 $0,0 0 Health Risk Aopraisal Motivation 0.00 $0.0 0 Respirator/Medical Review 6 2 $16.32 Treadmill (PFE) $156.00 $156.00 BIA Bio -Elec Im ed Anal $14.26 $14.28 Waist/Hi Ratio $3.06 $3.06 Flexibilitv Check S10,20 $10.20 Muscle Strength Endurance $26.52 $26.52 Vital Signs HT WT BP P R $0.00 so.001 Vision Titmus $26.52 26.52 PFT W/[nterrp $33.66 $33.66 Audiomet $14.28 14.28 ECG WI Interp $20.40 $20.40 Urinalysis Di stick $3,06 $3,06 Bladder Cancer Screen $45.90 $45.9 Love. Joseph B. Comprehensive Physical $99.96 $99.96 OnMed Program $0.00 $0.00 Health Risk Appraisal Motivation 0.00 $0.00 Respirator/Medical Review 16.32 $16.32 Treadmill (PFE) $156.00 $156.001 BIA Bio -Elec Im ed Anal 14.28 $14.28 Waist/Hi Ratio $3.06 $3.06 Flexibility Check $10,20 $10.2 0 Muscle Strength Endurance $26.52 $26.52 Chest PA/LAT $61.20 $61.20 Vital Sin HT WT BP P R $0.00 $0, Vision Tit s ----$2Q.52 $2&52 PFT W/Interp $33.66 $33.66 Audiomet $14.28 $14.28 ECG W/ Interp $20.40 $20.40 Urinalysis Dipstick $3.06 $3.06 Bladder Cancer Screen $45,90 $45.90 Mead Jr. Donald R. CMP $19.52 19.52 CBC WlDiff And Plat $17.68 $17.68 Lipid Panel $20.74 $20.74 Veni uncture Fee 3.06 $3.06 HIV 1 2 $13.26 $13.26 PSA $35,70 $35.70 INVOICE F o Public Safety Medical Services 324 E. New York Street E Suite 300 W Indianapolis, IN 46204 o Carmel Fire Department/ CARMEFD 2 Civic Square Terms Carmel, IN 46032 Invoice Date 08/25/2010 m Invoice 00 -13513 Date Employee Description Amount Balance Due Quantiferon Tb Gold $51.00 $51.00 Medlen Michael J. Qom rehensive Physical $99.96 $99.98 OnMed Pro ram 0.00 0.00 Health Risk Appraisal (M tiv ti .00 $0.0 Respirator/Medical Review $16.32 $16.32 Treadmill (PFE $156.00 $156.00 BIA Bio -Elec Im ed Anal $14.28 $14.28 Waist/Hi Ratio $3.06 $3.06 Flexibility Check $10.20 $10.2 0 Muscle Strength Endurance $26.52 $26.52 Chest PA/LAT $61,20 $61.20 Vital Signs HT WT BP P R $0.00 $0,00 Vision Titmus $26.52 $26.52 PFT W/Interp 133,66 $33.66 Audiometry 14.28 $14.28 ECG W/ Intern $20.40 120.4 0 Urinalysis Dipstick $3.06 $3.06 Bladder Cancer Screen $45.90 $45.90 Mitchell James C. Comprehensive Physical $99.96 $99.96 OnMed Program 0.00 $0.00 Health Risk Appraisal Motivation $0.00 $0.00 Respirator/Medical Review $16.32 16.32 Treadmill (PFE) $156.00 $156.00 BIA Bio -Elec Im ed Anal 14.28 $14.28 Waist/Hi Ratio $3.06 $3.06 Flexibility Check $10.20 $10.2 0 Muscle Strength Endurance $26.52 26.52 Vital Si HT WT BP P R $0,00 Vision Titmus $26.52 $26.52 PFT W/Interp $33.66 $33.66 Audiornetry $14.28 $14.28 ECG W/ Interp $20.40 20.40 Urinalysis Dipstick $3.06 $3.06 Bladder Cancer Screen $45.90 $45.90 Phillips, Craig M. Comprehensive Physical $99.96 $99.96 Hemoccult 0.00 $0,00 OnMed Program $0.00 $0.00 Health Risk ApDraisal Motivation 0.00 $0.00 Resuiratgr/MedigQl Review 11 .32 $16.32 Treadmill PFE $156.00 $156.0 BIA Bio -Elec Im ed Anal $14.28 $14.28 Waist/Hi Ratio $3.06 $3.06 Flexibility Check $10,20 $10.20 Muscle Strength Endurance $26.52 $26.52 Chest PA/LAT $61.20 $61.20 Vital Si ns HT WT BP P R $0.00 so.00 Vision Titmus $26.52 $26.52 INVOICE H Public Safety Medical Services 324 E. New York Street E Suite 300 Cr. Indianapolis, IN 46204 0 Carmel Fire Department 1 CARMEFD Terms F 2 Civic Square Carmel, IN 46032 Invoice Date 08125!2010 m Invoice 00 -13513 Date Employee Description Amount Balance Due PFT Wllnter $33.66 $33.66 Audiornetry $14.28 $14.28 ECG W/ Inter 20.40 $20.4 0 Urinalysis Dipstick $3.06 S3.06 Bladder Cancer Screen $45.90 $45.90 Robinson Mitchell L. Comprehensive Physical $99.96 $99.96 OnMed Program 0.00 $0.00 Health Risk Appraisal Motivation 0.00 $0.00 Respirator/Medical Review $16.32 $16.32 Treadmill PFE 156.00 $156.00 BIA (Bio-Elec Imped Anal $1428 14.2 Waist/Hi Ratio $3.06 $3.06 Flexibility Check $10.20 $10.20 Muscle Strength Endurance $26.52 $26.52 Vital Signs HT WT BP P R $0.00 $0.00 Vision Titmus 26.52 $26.52 PFT W/Interp $33.66 $33.66 Audiometry 14.28 $14.28 ECG W/ Interip $20.40 $20.40 Urinal sis Dipstick $3.06 $3.06 Bladder Cancer Screen $45,90 $45.90 Wendzel Jason D. CMP $19.52 $19.52 B W iff And Plat $17.68 $17.68 Li id Panel $20.74 $20.74 Veni uncture Fee $3.06 $3.06 HIV 1 &2 $13.26 $13.26 Quantiferon Tb Gold $51,00 $51,0 0 RBC Cholinesterase $45.90 $45.90 08/18/10 Collins, Tony A. Comprehensive Physical $99.96 99.96 OnMed Program $0.00 S0.001 Respirator/Medical Review $16,32 $16.32 Health Risk Appraisal Motivation 0.00 $0.00 Treadmill (PFE) $156.00 156.00 Flexibility Check $10.20 $10.2 Waist/Hi Ratio $3.0 Muscle Strength Endurance $26.52 $26.52 BIA Bio -Elec km ed Anai $14.28 $14.28 Bladder Cancer Screen $45,90 $45.90 Vital Signs HT WT BP P R $0.00 $0.00 Vision Titmus $26.52 $26.52 PFT W/Interp $33.66 33.66 Audiometry 14.28 $14,28 ECG W/ interp $20.40 $20,4 0 Urinalysis Dipstick $3.06 $3.06 DeLona, Michael T. Comprehensive Physical $99.96 $99.96 OnMed Pro ram $0.00 S0.00 INVOICE 0 Public Safety Medical Services 324 E. New York Street E Suite 300 d EY Indianapolis, IN 46204 G Carmel Fire Department I CARMEFD 2 Civic Square Terms Carmel, IN 46032 Invoice Date 08/25/2010 Invoice 00 -13513 Date Employee Description Amount Balance due Respirator/Medical Review S16,32 $16.32 Health Risk Apxaisal Motivation 0.00 0.00 Treadmill (PFE) $156.00 15600 Flexibilit he k $10,20 $10.2 0 Waist/Hi Ratio $3.66 $3.06 Muscle Strength Endurance $26.52 $26.52 BIA Bio -Elec Im ed Anal $14.28 $14.28 Vital Signs HT WT BP P R $0.00 $0.00 Vision Titmus $26.52 $26.52 PFT W/Interp $33.66 $33.66 AudiornetrV $14.28 $14.28 ECG W/ Interp $20.40 $20.40 Urinalysis Dipstick $3.06 $3.06 Bladder Cancer Screen $45.90 $45.90 Dorsch James E. Comprehensive Physical 99.96 $99.96 OnMed Program $0.00 $0.00 Respirator/Medical Review $16.32 $16.32 Health Risk Appraisal Motivation $0.00 $0.00 Treadmill (PFE) $156.00 $156.00 Flexibility Check $10.20 $10.2 0 Waist/Hi Ratio $3.06 $3,06 Muscle Strength Endurance $26.52 $26.52 BIA Bio -Elec Im ed Anal 14.28 $14.281 Vital Si ns HT WT BP P R 0.00 $0.00 Vision Titmus $26.52 $26.52 PFT W/Interip $33.66 $33.66 Audiomet 14.28 $14.28 ECG W/ Inter 20.40 $20.4 Urinalysis Dipstick $3.06 $3.06 Bladder Cancer Screen $45.90 $45.90 Drake Carl D. Comprehensive Physical $99.96 $99.96 OnMed Program $0.00 $0.00 Respirator/Medical Review $16.32 $16.32 Health Risk Appraisal f Motivation 0.00 0.00 Treadmill (PFE $156.00 $156.00 Flexibilitv Check $10.20 $10.20 Waist/Hi Ratio $3.06 $3.06 Muscle Strength Endurance $26.52 $26.52 BIA Bi -Ee m ed Anal 14.28 $14.28 Vital Sin HT WT BP P R $0.00 Vision Titmus $26.52 $26.52 PFT W/Interp $33.66 $33.66 Audiomet $14.28 $14.28 ECG W/ Interp $20.40 $20.40 Urinalysis Dipstick $3.06 $3.06 Bladder Cancer Screen $45.90 $45.90 Edwards Steven L. Comprehensive Physical $99.96 $99.96 INVOICE 0 Public Safety Medical Services 324 E. New York Street E Suite 300 d M Indianapolis, IN 46204 0 Carmel Fire Department CARMEFD 2 Civic Square Terms Carmel, IN 46032 Invoice Date 08/2512010 m Invoice 00 -13513 Date Employee Description Amount Balance Due OnMed Program $0.00 $0.00 Respirator/Medical Review $16.32 $16.32 Health Risk Appraisal Motivation 0.00 $0, 00 Treadmill (PFE $156.00 $156.00 Flexibility Check $10.20 $10.20 WaistlHi Ratio 3.06 $3.06 Muscle Strength Endurance $26.52 $26.52 BIA Bio -Elec Im ed Anal 14,28 14.28 Vital Signs HT WT BP P R $0.00 $0.00 Vision Titmus $26,52 $26.52 PFT W Inter Audiornetry $14.28 $14.28 ECG WI Interp $20.40 $20.40 Urinal sis Dipstick $3.06 $3.06 Bladder Cancer Screen $45.90 $45.90 Fa in. Timothy D. Comprehensive Physical $99.96 $99.96 OnMed Program $0.00 $0.00 Respirator/Medical Review $16.32 $16.32 Health Risk Apipraisal Motivation 0.00 $0.00 Treadmill (PPE) 156.00 $156.0 0 Flexlbilit Check $10.20 $10.20 WaisUl-lip Ratio $3.06 $3.06 Mu le Stren th Endurance $26. $26.52 BIA Bio -Elec Im ed Anal $14,28 $14.28 Bladder Cancer Screen $45.90 $45.90 Vital Signs HT WT BP P R $0.00 $0.00 Vision Titmus $26.52 $26.52 PFT W/interp $33.66 $33.66 Audiometry 14.28 $14.28 ECG W/ lnterp $20.40 $20,4 0 Urinalysis Di stick $3.06 $3.06 FGison,Bruce E. Comprehensive Physical $99.96 $99.96 OnMed Program $0.00 0.00 Resipirator/Medical Review $16. $16.32 Health Risk Appraisal M tiv tion 0.00 $0.00 Treadmill (PFE) $156.00 $156.00 Flexibility Check $10.20 $10,20 Waist/Hi Ratio $3.06 $3.06 Muscle Strength Endurance $26.52 $26.52 BIA Bio -Elec Im ed Anal 14.28 $14.28 Vital Signs HT WT BP P R $0.00 $0,00 Vision Titmus $26.52 $26.52 PFT W/Interp $33.66 $33.66 Audiomet 14.28 $14,28 ECG W1 Inter 20.40 $20.4 0 Urinalysis Dipstick $3.06 3.06 INVOICE s° Public Safety Medical Services 324 E. New York Street E Suite 300 v a Indianapolis, IN 46204 o Carmel Fire Department CARMEFp 2 Civic Square Terms Carmel, IN 46032 Invoice Date 08125/2010 m Invoice 00 -13513 Date Employee Description Amount Balance Due Bladder Cancer Screen $45.90 $45.90 Haboush David G. Comprehensive Physical S99.96 $99.961 OnMed Program $0.00 $0,00 Respirator/Medic.al Review $16.32 $1 6.32 Health Risk Appraisal Motivation $0.00 $0.00 Treadmill (PFE) $156.00 $156.00 Flexibility Check $10.20 $10.20 Waist/Hi Ratio $3.06 $3.06 Muscle Strength Endurance $26.52 $26,52 BIA Bio -Elec Im ed Ana! 14.28 $14.28 Bladder Cancer Screen $45.90 $45.90 Chest PA/LAT $61,20 $61.2 D Vital Si ns HT WT BP P R 0.00 $0.001 Vision Titmus $26.52 $26,52 PFT W /Inter 33.66 $33,66 Audiometry 14.28 $14.28 ECG W/ Interp $20.40 $20.40 Urinalysis Dipstick $3.06 $3.06 Hoffman. Matthew F. Comprehensive Physical $99.96 $99.96 OnMed Program $0.00 WOO Respirator/Medical Review 516.32 $16.32 Health Risk Appraisal Motivation 0.00 $0.00 Treadmill (PFE) $156.00 $156,00 Flexibility Check 110.20 110.2 0 Waist/Hi Ratio $3.06 $3,061 Muscle Strength Endurance $26.52 $26.52 BIA Bio -Elec Im ed Anal 14.28 $14.28 BI der Q Screen $45.90 4 .90 Vital Si ns HT WT BP P R $0.00 $0.00 Vision Titmus $26.52 $26.52 PFT WAnterp $33.66 $33.66 Audiornetry $14.28 $14.28 ECG W/ Inter 20.40 20.40 Urinalysis Dipstick $3.06 $3.06 CMP $19.52 $19.52 CBC W /Dill And Plat $17.68 $17.681 Lipid Panel $20.74 2014 Veni uncture Fee $3.06 $3.06 Qua nfiferon Tb Gold 1.0 1. 0 M w Aothony W. Comprehensive Physical $99.96 $99.9 OnMed Program $0.00 $0.00 Respirator/Medical Review $16.32 $16.32 Health Risk Appraisal Motivation $0.00 $0.00 Treadmill (PFE) $156.00 $156.00 Flexibility Check $10.20 $10.2 0 Waist/Hi Ratio $3.06 3.06 Muscle Strencith Endurance $26.52 2fi.52 INVOICE 0 Public Safety Medical Services 324 E. New York Street E Suite 300 d M Indianapolis, IN 46204 0 Carmel Fire Department I CARMEFD F 2 Civic Square Terms Carmel, IN 46032 Invoice Date 08125!2010 m Invoice 00 -13513 Date Employee Description Amount Balance Due BIA Bio -Elec Im ed Anal $14.28 $14.28 Vital Signs HT WT BP P R $0.00 $0.00 Vision Titmus 26.52 $26.52 PFT W /Inter 3166 $33.66 Audiometry 14.28 S14.28 ECG W/ inter 20.40 $20.40 Urinalysis Di stick $3.06 $3.06 Bladder Cancer Screen $45.90 $45.90 Paddock Ronald D. Comprehensive Physical $99.96 S99.96 OnMed Program $0.00 SO.D01 R iralQrIM ical Review $16.32 S16.32 Health Risk Appraisal Motivation $0.00 $0.00 Treadmill (PFE) $156.00 $156.00 Flexibility Check $10.20 $10.20 Waist/Hi Ratio $3,06 $3.06 Muscle Strength Endurance $26.52 $26.52 BIA Bio -Elec Im ed Anal 14.28 $14.28 Bladder Cancer Screen $45.90 $45.90 Vital Signs HT WT BP P R $0.00 $0.00 Vision Titmus $26.52 $26.52 PFT W/Interip $33.66 $33.66 Audiomet 14.28 $14.28 CG I t rip 120.40 .4 Urinalysis Dipstick $3.06 $3.06 R an. Christopher D. Comprehensive Phvsical $99.96 $99.96 OnMed Pro ram 0.00 $0.00 Respirator/Medical Review 16.32 $16.32 Health Risk Appraisal Motivation 0.00 $0.00 Treadmill (PFE) $156.00 $156.00 Flexibility Check $10.20 $10.20 Waist/Hi Ratio $3.06 3.06 Muscle Strength Endurance $26.52 $26.52 BIA Bio -Elec Im ed Anal 14.28 $14.28 Blodder Cancer Screen 4 9Q 14 0 Vital i n HT WT BP P R $0.00 $0.00 Vision Titmus $26.52 $26.52 PFT W/Interp $33.66 $33.66 Audiometry $14.28 $14.28 ECG W/ Interp $20.40 $20.40 Urinalysis Dipstick $3.06 $3.06 08/19/10 Beskerville Steven R Comprehensive Physical 99.96 $99.96 OnMed Program $0.00 $0.00 Respirator/Medical Review $16,32 $16.32 Health Risk Appraisal Motivation 0.00 0.00 Treadmill (PFE) $156.00 $156.00 Flexibility Check $10.20 $10.20 V INVOICE M Public Safety Medical Services 324 E. New York Street E Suite 300 0: Indianapolis, IN 46204 C Carmel Fire Department CARMEF© r- 2 Civic Square Terms Carmel, IN 46032 Invoice Date 0812512010 Invoice 00.13513 Date Employee Description Amount Balance Due WaisUHi Ratio $3.06 $3.06 Muscle Strencith Endurance $26.52 $26.52 BIA Bio -Elec Im ed Anal 14.28 $14.28 Vital SiQn5 HT WT BP P R $0.00 Vision Titmus $26.52 $26 PFT W/Interp $33.66 $33.66 Audiomet $14.28 $14.28 ECG W/ Interp $20.40 20.40 Urinalysis Dipstick $3.06 $3.06 Bladder Cancer Screen $45.90 $45.90 Chest PA/LAT $61.20 $61.20 Benbow Kip S. Bladder Cancer Screen $45.90 45.90 Comprehensive Physical 99.96 $99.96 OnMed Program $0.00 $0.00 Respirator/Medical Review $16.32 $16.32 Health Risk A raisal Motivation 0.0 0.00 Treadmill (PFE) $156.00 $156.00 Flexibility Check $10.20 $10.20 Waist/Hi Ratio $3.06 $3.06 Muscle Strength Endurance $26.52 $26.52 BIA Bio -Elec Im ed Anal 14.28 $14.28 Vital Signs HT WT BP P R $0.00 $0.00 Vision Titmus $26.52 $26.52 PFT W/Interp $33.66 $33.66 Audiornetry $14.28 $14.28 ECG W1 Interp $20.40 20.40 Urinalysis Di stick S3,06 $3.06 haw, Jeffrey A. C m r h n iv Ph i t 9.9 9 6 OnMed Program $0.00 $0.00 Respirator/Medical Review $16.32 $16.32 Health Risk Appraisal Motivation $0.00 $0.00 Treadmill (PFE) $156.00 $156.00 Flexibility Check $10.20 $10.2 0 Waist/Hi Ratio $3.06 $3.06 Muscle Strength Endurance $26.52 $26.52 BIA Bio -Elec Im ed Anal 14.28 $14,28 Vital Signs HT WT BP P R $0.00 $0.00 Vision Titmus $26.52 $26.52 PFT W /Inter 3.66 31 Audiomet 14.28 $14.28 ECG W/ Interp $20.40 $20.40 Urinalysis Dipstick $106 $106 Bladder Cancer Screen $45.90 $45.90 Fisher Gary L. Repeat CBC W /dill& Plat $17.68 $17.68 Martin David D. Comprehensive Physical 99.96 99.96 OnMed Pro ram $0.00 0.00 Res irator /Medical Review 16.32 16.32 INVOICE 0 Public Safety Medical Services 324 E. New York Street E Suite 300 x Indianapolis, IN 46204 G Carmel Fire Department 1 CARMEFD 2 Civic Square Terms Carmel, IN 46032 Invoice Date 08/25/2010 m Invoice 00 -13513 Date Employee Description Amount Balance Due Health Risk Appraisal Motivation $0.00 $0.00 Treadmill (PFE $156.00 156.0D Flexibilitv Check $10.20 $10.20 Waist/Hi Ratio $3.06 $3.06 Muscle Strength Endurance $26.52 26.52 BIA Bic -Elec Im ed Anal 14.28 $14.28 Vital Signs HT WT BP P R $0.00 $0.00 Vision Titmus $26.52 $26.52 PFT W11nterQ $33.66 133.66 Audiometry 14.28 $14.28 ECG LNI Inter 2 .4 .4 Urinalysis Dipstick $3.06 $3.06 Bladder Cancer Screen $45.90 $45.90 Martin Richard A. Comprehensive Physical $99.96 $99,96 OnMed Program $0.00 $0.00 Respirator/Medical Review $16.32 $16,32 Health Risk Appraisal Motivation 0.00 $0.00 Treadmill (PFE) $156.00 $156.00 Flexibility Check $10.20 $10.2 0 Waist/Hi Ratio $3.06 $3.06 Muscle Strength Endurance $26.52 $26.52 BIA Bio -Elec Im ed Anal 14.28 $14.28 Vital Signs HT WT BP P R $0.00 $0.0 D Vision Titmus $26.52 $26.52 PFT W/Interp $33.66 $33.66 Audiometry $14.28 $14.28 ECG Wl Inter 2040 $20.40 Urinal sis Dipstick $3.06 $3.06 Bladder Cancer Screen $45.90 45.90 Osborne Scott K. Comprehensive Physical $99.96 $99.96 OnMed Program 0.00 $0.00 Res iratorlMedicai Review $16,32 16.32 Health Risk Appraisal Motivation 0.00 0.00 Treadmill (PFE) S156 0 S156.00 Flexibility Check $10.20 $10,20 Waist/Hi Ratio $3.06 $3.06 Muscle Strength Endurance $26.52 $26.52 BIA Bio -Elec Im ed Anal 14.28 $14.28 Vital Signs HT WT BP P R $0.00 $0.00 Vision Titmus $26.52 $26.52 PFT Wllnter 33.66 $33,66 Audiometry 14.28 $14.28 ECG W1 Intere $20.40 $20.40 Urinal sis Dipstick $3.06 $3.06 Bladder Cancer Screen $45.90 45.90 Peterson Vernon A, Comprehensive Physical $99.96 99.96 INVOICE 0 Public Safety Medical Services 324 E. New York Street E Suite 300 W Indianapolis, IN 46204 Carmel Fire Department! CARMEFD Terms 2 Civic Square Carmel, IN 46032 Invoice Date 08125!2010 ED Invoice 00 -13513 Date Employee Description Amount Balance Due OnMed Program $0.00 $0.00 Respirator/Medical Review $16.32 $16.321 Health Risk Aporaisai Motivation 0.00 $0.00 Treadmill PFE 156.00 $15 0 Flexibility Check $10.20 $10.20 Waist/Hi Ratio $3.06 $3.06 Muscle Strength Endurance $26.52 $26.52 BIA Bio -Elec Im ed Anal 14.28 $14.281 Chest PA/LAT 61.20 $61.20 Vital Signs HT WT BP P R $0.00 $0.00 Vision Titmus $26.52 $26.52 PFT W/Interp $33.66 $33.66 Audiomet 14.28 14.28 ECG WI Interip $20.40 $20.40 Urinalysis Dipstick 13.06 $3.06 Bladder Cancer Screen $45.90 $45.90 Sombke Brad D. Comprehensive Physical $99.96 $99.96 OnMed Program $0.00 $0.00 Respirator/Medical Review $16.32 $16.32 Health Risk Appraisal Motivation $0.00 $0.00 Treadmill (PFE) $156.00 $156.00 Flexibility Check $10.20 $10.20 Waist/Hi Ratio $3.06 $3.06 Muscle Strength Endurance $26.52 26.52 BIA Bio -Elec Im ed Anal 14.28 14.28 Vital Signs HT WT BP P R $0.00 $0.00 Vision Titmus $26.52 $26.52 PFT W Inter 3166 $33.66 Audiometry $14.28 $14.28 ECG W/ Interp $20.40 $20.40 Urinalysis Di stick $3.06 $3.06 Bladder Cancer Screen $45.90 $45.90 Steurv, Kent C. Comprehensive Physical $99.96 $99.96 OnMed Program $0.00 $0.00 Respirator/Medical Review $16.32 $16.32 Health Risk Apnraisal Motivation 0.00 0.00 Treadmill (PFE) $156.00 $156.00 Flexibility Check $10.20 $10.2 0 Waist /Hi Ratio $3.06 $3.06 Muscle S ren th Endurance 26. 2 BIA Bio -Elec Irn ed Anai $14.28 $14.28 Vital Signs HT WT BP P R $0.00 $0.00 Vision Titmus $26.52 $26.52 PFTW/Interp $33.66 $33.66 Audiornetry $14.28 $14,28 ECG W/ Inter 20.40 $20.4 0 urinalysis Dipstick $3.06 $3.06 INVOICE o Public Safety Medical Services 324 E. New York Street E Suite 300 Indianapolis, IN 46204 G Carmel Fire Department 1 CARMEFD 2 Civic Square Terms Carmel, IN 46032 Invoice Date 08125I2010 m Invoice 00 -13513 Date Employee Description Amount Balance Due Bladder Cancer Screen $4590 $45.90 Sutton. Sean B. Comprehensive Physical $99.96 $99.96 OnMed Program $0.00 $0.00 Respirator/Medical Review $16.32 $16.32 Health Risk Appraisal Motivation 0.00 $0.00 Treadmill (PFE) $156.00 $156.00 Flexibility Check $10.20 10.20 Waist!Hi Ratio $3.06 $3.06 Muscle Strength Endurance 26.52 $26.52 BIA Bio -Elec Im ed Anal 14.28 $14.28 Vital Si HT WT BP P R $Q, DO Vision Titmus $26.52 $26.52 PFT W/Interp $33.66 $33.66 Audiometry $14.28 $14.28 ECG W/ Interp $20.40 $20.40 Urinalysis Dipstick $3,06 13.06 Bladder Cancer Screen $45,90 $45.90 Witsken Steven J. Comprehensive Physical $99.96 $99.96 OnMed Program $0.00 0.00 Respirator/Medical Review $16.32 $16.32 Health Risk Appraisal Motivation 0.00 $0.00 Treadmill f PFE 156.00 S156.D0 Flexibility h 10.20 $10.20 Waist/Hi Ratio $3.06 $3.06 Muscle Strength Endurance $26.52 $26.52 BIA Bio -Elec Im ed Anal 14.28 $14.28 Vital Signs HT WT BP P R $0. DO so, 00 Vision Titmus $26.52 $26.52 PFT W/Interp $33.66 3166 Audiometry $14.28 $14.28 ECG W/ Interp $20.40 $20.40 Urinalysis Dipstick $3.06 $3,06 Bladder Cancer Screen $45.90 $45.90 Zeller, i ha I J. Comprehensive Ph i al $99.96 $99 OnMed Pro ram $0.00 $0.00 Respirator/Medical Review $16.32 $16.32 Health Risk Appraisal Motivation $0.00 $0.00 Treadmill (PFE) $156.00 $156.00 Flexibility Check $10.20 $10.20 WaistlHi Ratio $3.06 $3.06 Muscle Strength Endurance 26.52 $26.52 BIA Bio -Elec Im ed Anal 14.28 $14.28 Vital Signs HT WT BP P R 0.00 $0.00 Vision Titmus $26.52 $26.52 PFT W/Intern $33.66 33.66 Audiometry $14,28 $14.28 INVOICE o Public Safety Medical Services 324 E. New York Street E Suite 300 a) tY Indianapolis, IN 46204 C Carmel Fire Department 1 CARMEFD F 2 Civic Square Terms Carmel, IN 46032 Invoice Date 08!25!2010 co Invoice 00.13513 Date Employee Description Amount Balance Due ECG W/ Intern $20.40 $20.40 Urinalysis Di stick $3.06 $3.06 Bladder Cancer Screen $45.90 $45.90 08/201 DeCrastos. Richard A. Comprehensive Physigad $99.96 $99 OnMed Program $0.00 $0.00 Respirator/Medical Review $16.32 $16.32 Health Risk Appraisal Motivation $0.00 $0.00 Treadmill (PFE $156.00 $156.00 Flexibility Check $10.20 $10.2 0 Waist/Hi Ratio $3.06 $3.06 Muscle Strength Endurance $26.52 $26.52 BIA Bio -Elec Im ed Anal 14.28 $14,28 Vital Signs HT WT BP P R $0.00 $0.00 Vision Titmus 26.52 $26.52 PFT W/Interl2 $33.66 $33.66 Audiometry 14.28 $14.28 ECG W/ Interp $20.40 $20.40 Urinalysis Dipstick $3.06 $3.06 Bladder Cancer Screen $45.90 $45.90 Fuchs Jeffery W. Comprehensive Physical $99.96 $99.96 OnMed Program $0.00 $0.00 Respirator/Medical Review $16.32 $16.32 Health Risk Appraisal Motivation 0.00 $0.Q0 Treadmill (PFE) $156.00 $156.0 0 Flexibility Check $10,20 $10.2 0 Waist/Hi Ratio $3.06 $3.06 Muscle Strength Endurance $26.52 $26.52 BI i- m Ani 14.28 $14.2 Vital Signs HT WT BP P R $0.00 $0.00 Vision Titmus $26.52 $26.52 PFT W/Interp $33.66 $33.66 Audiornetry $14.28 $14.28 ECG W/ Interp $20.40 $20.4 D Urinalysis Dipstick $3.06 $3.06 Bladder Cancer Screen $45.90 $45.90 Gu el Mark E. Comprehensive Physical $99,96 $99.96 OnMed Program $0.00 $0.00 Respirator/Medical Review 16.32 $16.32 Health R sk r is M tiv ti n 0. Treadmill (PFE $1 6.00 $156. Flexibility Check $10.20 $10.20 Waist/Hi Ratio $3.06 $3.06 Muscle Strength Endurance $26.52 $26.52 BIA Bio -Elec Im ed Anal $1428 $14.28 Vital Signs HT WT BP P R $0.00 $0.00 Vision Titmus $26,52 $26.52 PFT W/Interp $33.66 $33.66 INVOICE 0 Public Safety Medical Services 324 E. New York Street E Suite 300 W. Indianapolis, IN 46204 C Carmel Fire Department I CARMEFD 2 Civic Square Terms r Carmel, IN 46032 Invoice Date 0812512010 m Invoice 00 -13513 Date Employee Description Amount Balance Due Audiornetry $14.28 $14.28 ECG W1 Inter 20.40 $20.40 Urinalysis Dipstick $3.06 $3.06 Bladder Cancer Screen $45.90 $45.90 Horner David W. Comprehensive Physical $99.96 $99.96 OnMed Pro ram $0,00 $0.00 Res iratorlMedical Review $16.32 $16,32 Health Risk Appraisal Motivation 0.00 $0.00 Treadmill (PFE 156.00 $156.00 Flexibility Check $10.20 $10.20 Waistlft Ratio $3.06 $3.0 Muscle Strength Endurance $26.52 $26.52 BIA Bio -Elec Im ed Anal 14.28 $14.28 Chest PA/LAT $61.20 $61.20 Vital Signs HT WT BP P R $0.00 $0,00 Vision Titmus $26.52 $26.52 PFT W/Interp $33.66 $33,66 AudiornetrV $14.28 $14.28 ECG W/ Interp $20.40 $20.40 Urinalysis Dipstick $3.06 $3.06 Bladder Cancer Screen $45.90 $45.9G Lenze Theodore A. Com rehensive Physical $99.96 199.96 O nMed Program SO.00 $0.00 Respirator/Medical Review $16.32 $16.32 Health Risk Appraisal Motivation $0.00 $0.00 Treadmill (PFE $156.00 $156.00 Flexibilitv Check $10.20 102 0 Waist/Hi Ratio $3.06 $3.06 Muscle Strength Endurance $26.52 $26.52 BIA Bio -Eiec Im ed Anal 14.28 $14.28 Chest PA/LAT $61.20 $61.20 Vital Si ns HT WT BP P R $0.00 $0.00 Vision Titmus $26.52 26.52 PTWntr 36 $33.66 Audiometry $14.28 $14.2 ECG W/ Interp $20.40 $20.40 Urinalysis Dipstick $3.06 $3.06 Bladder Cancer Screen $45.90 $45.90 Lux Michael T. Comprehensive Phvsical $99.96 $99.96 OnMed Pro ram $0.00 0.00 Respirator/Medical Review 16.32 16.32 Health Risk Appraisal Motivation 0.00 $0.00 Treadmill (PFE) $156.00 $156.00 Flexibility Check $10.20 $10.2 0 Waist /Hi Ratio $3.06 $3.06 Muscle Strength Endurance $26,52 $26.52 INVOICE o Public Safety Medical Services 324 E. New York Street E Suite 300 ry m Indianapolis, IN 46204 C Carmel Fire Department CARMEFD 2 Civic Square Terms Carmel, IN 46032 Invoice Date 08/25/2010 m Invoice 00 -13513 Date Employee Description Amount Balance Due BIA Bio -Elec Im ed Anal 14.28 $14.28 Chest PA/LAT 161.20 $61.20 Vital Signs HT WT BP P R $0.00 SO.00 Vision Titmus 126J2 $26.52 PFT W/Interp $33.66 $33.66 Audiametry $14.28 $14.28 ECG W/ Interp $20.40 $20.40 Urinalysis Dipstick 3.06 $3.06 Bladder Cancer Screen $45.90 $45.90 Smith Brian E. Comprehensive Physical $99.96 $99.96 OnMed Program $0. 00 $0.00 Respirator/Medical Review $16.32 $16.32 Health Risk A raisal Motivation 0.00 $0.00 Treadmill (PFE) $156.00 $156.00 Flexibility Check $10.20 $10.20 Waistfflb Ratio $3.06 $3.06 Muscle Strength Endurance $26.52 $26.52 BIA Bio -Elec Im ed Anal $14.28 $14.28 Vital Signs HT WT BP P R $0.00 $0.00 Vision Titmus $26.52 $26.52 PFT W/Interp $33.66 $33.66 Audiometry 14.28 $14.28 ECG W/ Interp $20.40 $20.4 0 Urinalysis Di stick $3,06 $3.06 Bladder Cancer Screen $45.90 $45.90 Utzig, Todd T. Comprehensive Physical $99.96 $99.96 OnMed Program $0,00 $0,00 Re it for Me ical Review $16.32 $1 6.32 Health Risk Appraisal Motivation $0.00 $0.00 Treadmill (PFE) $156.00 $156.00 FlexibilftV Check $10.20 $10.20 Waist/Hi Ratio $3.06 $3.06 Muscle Strength Endurance $26.52 $26,52 BIA Bio -Elec Im ed Anal 14.28 14.28 Chest PA/LAT $61.20 $61.2 0 Vital Signs HT WT BP P R $0.00 $0.00 Vision Titmus $26.52 $26.52 PFT W/Interp $33.66 $33.66 udi m t 14,28 $14,2 E W Inter 20.40 $20.4 0 Urinalysis Dipstick $3.06 $3.06 Bladder Cancer Screen $45.90 $45.90 Voskuhl Mark J. Comprehensive Physical $99.96 $99.96 OnMed Program $0.00 $0.00 Res irator /Medical Review 16.32 $16.32 Health Risk Appraisal Motivation 0.00 $0.00 Treadmill (PFE) 1 $156.00 $156.00 INVOICE H Public Safety Medical Services 324 E. New York Street E Suite 300 .d W Indianapolis, IN 46204 o Carmel Fire Department 1 CARMEFD t- 2 Civic Square Terms Carmel, IN 46032 Invoice Date 09/03/2010 m Invoice 9 00 -13561 Date Employee Description Amount Balance Due 08/23110 Brant Kenneth E. Comprehensive Physical $99.96 $99.96 OnMed Program $0.00 $0.00 Health Risk Appraisal Motivation 0.00 $0.00 Res irator /Medical Review $16.32 $16.32 Treadmill (PFE) $156.00 156.00 BIA Bio -Elec Im ed Anal 14.28 $14.28 Waist/Hi Ratio 3.06 $3.06 Flexibilitv Check $10.20 $10.20 Muscle Strength Endurance $26.52 $26,52 Chest PA/LAT $61.20 $61.20 Vial Signs H T WT BP P Vision Titmus $26.52 $26.52 PFT W/Interp $33.66 $33.66 Audiometry 14.28 $14.28 ECG W1 Interp $20.40 $20.4 0 Urinalysis Di stick $3.06 13.06 Bladder Cancer Screen $45.90 $45.90 Conner Timothy L. Comprehensive Physical $99.96 $99,961 OnMed Program $0.00 $0.00 Health Risk Aapraisal Motivation 0.00 $0.00 Respirator/Medical Review $16.32 $16.32 Treadmill (PFE) $156.00 $156.00 BIA is lec Imped Analyl 14. 14 Waist/Hi Ratio $3.06 $3.06 Flexibilitv Check $10.20 $10.20 Muscle Strength Endurance $26.52 $26.52 Chest PA/LAT $61.20 61.20 Vital Signs HT WT BP P R $0.00 $0.00 Vision Titmus 26.52 $26.52 PFT W/Interp 33.66 $33.66 Audiometry 14.28 $14.28 ECG W/ Inter 20.40 $20.4 0 Urinalysis Di stick $3.06 $3.06 Bladder Cancer Screen $45.90 $45.90 Da vis, m M. Comproh nsive Physical $99.96 OnMed Program $0.00 $0.00 Health Risk Appraisal Motivation $0.00 $0.00 Res irator /Medical Review $16.32 $16.32 Treadmill (PFE $156.00 $156.00 BIA Bio -Elec Im ed Anal $14.28 $14.28 WaisUHi Ratio 3.06 $3.06 Flexibilitv Check $10,20 $10.20 Muscle Strength Endurance $26.52 26.52 Vital Si ns HT WT BP P R $0.00 $0.00 Vision Titmus $26.52 $26,52 PFT W/Interp $33.66 $33.66 INVOICE H Public Safety Medical Services 324 E. New York Street E Suite 300 W Indianapolis, IN 46204 C Carmel Fire Department 1 CARMEFD 2 Civic Square Terms Carmel, IN 46032 Invoice Date 09/0312010 Invoice 00 -13561 Date Employee Description Amount Balance Due Audiomet 14.28 $14.28 ECG W/ Interip $20.40 S20.40 Urinalysis Di stick $3.06 $3.06 B ladder r Screen $45.90 $4 5.90 Hutchison, Brian P. Comprehensive Physical $99.96 $99.96 OnMed Program $0.00 $100 Health Risk Appraisal Motivation 0.00 $0.00 Respirator/Medical Review $16,32 $16.32 Treadmill (PFE) $156.00 $156.00 BIA Bic -Elec Im ed Anal 14.28 $14.28 WaisUft Ratio $3.06 $3.06 Flexibility Check 510.20 $10.20 Muscle Strength Endurance $26.52 $26.52 Vital Sign HT WT BP P R $0.00 $0.00 Vision -Tit us $26.52 $26.52 P T W/Interp S33.66 $33.66 Audiomet $14.28 $14.28 ECG WI Interp $20.40 $20.40 Urinalysis Dipstick $3.06 $3.06 Bladder Cancer Screen $45.90 $45.90 Maners Jeremy B. Comprehensive Physical $99.96 $99.96 OnMed Program $0.00 $0.00 Health Risk ApUraisal Motivation 0.00 $0.00 Respirator/Medical Review 16.32 $16.32 Treadmill (PFE $156.00 $156.00 BIA Big -Elec Im ed Anal 14.28 $14.28 Waist/Hit) Ratio $3.06 $3.06 Fein C 1 Muscle Strength Endurance $26.52 $26.52 Vital Sig HT WT BP P R $0.00 $0.00 Vision Titmus $26.52 26.52 PFT W/Interp $33.66 $33.66 Audiometry 14.28 $14.28 ECG W/ Interp $20.40 $20,40 Urinal sis Dipstick $3.06 $3.06 Bladder Cancer Screen $45.90 $45.90 Marcum. Bradle y D. Comixehensive Physical $99.96 $99.96 OnMed Program $0.00 $0.00 Health Risk A rais I Motivation 0.00 so.00l Respirator/Medical rator/Medical Review $16,32 Treadmill (PFE) $156.00 $156.00 BIA Bio -Elec Im ed Anal $14.28 $14.28 Waist /Hi Ratio $3,06 $3.06 Flexibility Check 10.20 $10.20 Muscle Strength Endurance $26.52 $26.52 Vital Si ns HT WT BP P R $0.00 $0.00 Vision Titmus $26.52 $26.52 INVOICE 0 Public Safety Medical Services 324 E. New York Street W Suite 300 it Indianapolis, IN 46204 G Carmel Fire Department 1 CARMEFD f 2 Civic Square Terms Carmel, IN 46032 Invoice Date 0910312010 m Invoice 00 -13561 Date Employee Description Amount Balance Due PFT W/Interp $33.66 $33.66 Audiornetry $14.28 $14.28 ECG W/ Inter 20.40 $20.4 0 Urinalysis Dipstick $3.06 $3.06 Bladder Cancer Screen $45.90 $45.901 Mason Bryan L. PFT W/Interip $33.66 $33.66 Audiometry 14.28 $14.28 ECG WI Interp $20.40 $20.4 0 Urinalysis Dipstick $3.06 $3.06 Comprehensive Physical $99.96 $99.96 OnMed Proararn $0.00 so.001 Health Risk Appraisal Motivation $0.00 $0.00 Respirator/Medical Review $16.32 $16.32 Treadmill (PFE) $156.00 $156.00 BIA Bio -Elec Im ed Anal 14.28 14.28 Waist/Hi Ratio $3.06 $3.06 Flexibility Check $10.20 $10.201 Muscle Stren th Endurance $26.52 $26.52 Chest PA/LAT $61.20 $61.20 Bladder Cancer Screen $45,90 $45.90 Vital Signs HT WT BP P R $0.00 $0.00 Vision Titmus $26.52 $26,52 Mead. David o re e Physical $99.96 $99,9 OnMed Program $0.00 $0.00 Health Risk Appraisal Motivation $0.00 $0.00 Res iratorlMedical Review $16.32 $16.32 Treadmill (PFE) $156.00 $156.00 BIA Bio -Elec Im ed Anal 14.28 $14.28 Waist/Hi Ratio $3.06 $3.06 Flexibility Check $10.20 $10.20 Muscle Strength Endurance $26.52 $26.52 Vital Si ns HT WT BP P R $0.00 100 Vision Titmus $26.52 $26-52 PFT Wllnter 33.66 $33.66 Audiometry 14.28 $14.2 ECG W/ Interp $20.40 $20.40 Urinalysis Dipstick $3.06 $3.06 Bladder Cancer Screen $45.90 $45.90 Mulford, David A. Comprehensive Physical $99.96 $99.96 OnMed Program $0.00 $0.00 Health Risk Appraisal Motivation 0.00 $0.00 Res iratorlMedical Review $16.32 $16.32 Treadmill (PFE $156.00 156.00 BIA Bio -Elec Im ed Anal 14.28 $14.28 Waist/Hi Ratio $3.06 $3.06 Flexibility Check $10.20 1 .2 INVOICE H Public Safety Medical Services y 324 E. New York Street E Suite 300 m ix Indianapolis, IN 46204 o Carmel Fire Department 1 CARMEFD 2 Civic Square Terms Carmel, IN 46032 Invoice Date 09103/2010 m Invoice 00 -13561 Date Employee Description I Amount Balance Due Muscle Stren th Endurance $26.52 $26.52 Vital Si ns HT WT BP P R 0.00 0.00 Vision Titmus 26.52 $26.52 PFT r Audiometry $14.28 $14.28 ECG W/ Interp $20.40 $20.40 Urinalysis Dipstick 3.06 $3.06 Bladder Cancer Screen $45.90 $45.90 Schooley Dustin D. Com rehensive Physical $99.96 $99.96 OnMed Program $0.00 $0,00 Health Risk Appraisal Motivation 0.00 0.00 Respirator/Medical Review $16.32 $16.32 Treadmill (PFE) $156.00 $156.00 BIA Bio -Elec Im ed Anal 14.28 $14.28 Waist/Hi Ratio $3.06 $3.06 Flexibilitv Check I S10. Muscle Strength Endurance $26.52 $26.52 Chest PA/LAT $61.20 $61.20 Vital Signs HT WT BP P R 0.00 0.00 Vision Titmus 26.52 $26.52 PFT W/Interp 133.66 $33.661 Audiometry 14.28 $14.28 ECG W/ inter 20.40 $20.4 0 Urinalysis Dipstick $3.06 3.06 Bladder Cancer Screen $45.90 $45.90 Strou Scott A. Comprehensive Physical $99.96 $99.96 OnMed Pro ram $0.00 $0.00 H ealth Ri k A r i I i Respirator/Medical Review $16.32 $16.32 Treadmill (PFE) $156.00 $156.00 BIA Bio -Elec Im ed Anal 14.28 14.28 WaisUft Ratio $3.06 3.06 Flexibility Check 10.20 $10.2 0 Muscle Strength Endurance 26.52 $26.52 Chest PA/LAT 61.20 $61.2 0 Vital Si ns HT WT BP P R $0.00 0.00 Vision Titmus 12 fi.52 126.52 PFT W/Interp $33.66 $33.66 Audiometry 14.28 $14.28 $20. $20.4 Urinalysis Dipstick $3.06 $3.06 Tb Skin Test $7.14 1 $7.14 Bladder Cancer Screen $45.90 $45.90 Weddin ton Kurt L. Comprehensive Physical 199.96 $99.96 OnMed Program $0.00 0.00 Health Risk Appraisal Motivation 0.00 0.00 Respirator/Medical Review $16.32 INVOICE 0 Public Safety Medical Services 324 E. New York Street E Suite 300 W Indianapolis, IN 46204 C Carmel Fire Department CARMEFD 2 Civic Square Terms Carmel, IN 46032 Invoice Date 09103I2010 m invoice 00 -13561 Date Employee Description Amount Balance Due Treadmill (PFE) $156.00 156.00 BIA Bio -Elec Im ed Anal 14.28 $14.28 Waist/Hi Ratio $3.06 $3.06 Flexibility Check $10.20 $10.20 Muscle Strength Endurance 26.52 $26.52 Vital Signs HT WT BP P R 0.00 $0.00 Vision Titmus $26.52 $26.52 PFT W/Interip $33.66 $33.66 Audiomet 14.28 $14.28 ECG W/ Inter 20.40 $20.40 Uri nalysis [Dbstick $3.06 $3.06 Bladder Cancer Screen $45.90 $45.90 08/24/10 Baskerville Anthony A. Comprehensive Physical $99.96 $99.96 OnMed Program $0.00 $0.00 Health Risk Appraisal Motivation 0.00 $0.00 Respirator/Medical Review $16.32 $16.32 Treadmill (PFE $156.00 $156.00 BIA Bio -Elec Im ed Anal 14.28 $14.28 Waist/Hi Ratio $3.06 $3.061 Flexibility Check $10.20 $10,20 Muscle Strencith Endurance $26.52 $26.52 Vital Signs HT WT BP P R $0.00 $0.00 Vision Titmus $26.52 PFT W/Interp $33.66 $33.66 Audiomet $14.28 $14.28 ECG W1 Inter $20.40 $20.40 Urinalysis Dipstick $3.06 $3.06 Bladder Cancer Screen $45.90 $45.90 Condra Kyle E. Comprehensive Physical $99.96 $99.96 OnMed Program $0.00 $0.00 Health Risk Appraisal Motivation 0.00 $0.00 Respirator/Medical Review $16.32 $16.32 Treadmill (PFE) $156.00 $156.0 0 BIA Bio -Elec Im ed Anal 14.28 $14.28 W Hi Flexibility Check $10.20 $10.20 Muscle Strength Endurance $26.52 $26.52 Chest PA/LAT $61.20 $61.20 Vital Signs HT WT BP P R $0.00 $0.00 Vision Titmus $26.52 $26.52 PFT W/Interp $33.66 $33.66 Audiometry 14.28 $14.28 ECG W/ Interp $20.40 $20.4 0 Urinalysis Di stick $3.06 $3.06 Bladder Cancer Screen $45.90 $45.90 Edwards Daniel E. Com rehensive Physical $99. 99.96 INVOICE H Public Safety Medical Services 324 E. New York Street Suite 300 Indianapolis, IN 46204 o Carmel Fire Department I CARMEFD 2 Civic Square Terms Carmel, IN 46032 Invoice Date 0910312010 m Invoice 00 -13561 Date Employee Description Amount Balance Due OnMed Program $0.00 $0.00 Health Risk A rais i Motivation 0.00 $0.00 Respirator/Medical Review $16.32 $16.32 Treadmi P $156.00 15 BIA Bio -Elec Im ed Anal $14.28 $14.28 Waist/Hi Ratio $3.06 $3.06 Flexibility Check $10.20 $10.20 Muscle Strength Endurance $26.52 $26.52 Vital Signs HT WT BP P R 0.00 $0.00 Vision Titmus $26.52 $26.52 PFT W/Interp $33.66 $33.66 Audiometry 14.28 $14.28 ECG W1 Interp $20.40 $20.40 Urinalysis Dipstick $3.06 $3.06 Bladder Cancer Screen $45.90 $45.90 Hulett, r A. Comprehensiv OnMed Program $0.00 $0.00 Health Risk Appraisal Motivation $0.00 $0.00 Respirator/Medical Review 16.32 $16.32 Treadmill (PFE $156.00 $156.00 BIA Sic -Elec Im ed Anal 14.28 $14.28 Waist/Hi Ratio $3,06 $3.06 Flexibility Check $10.20 $10.2 0 Muscle Strength Endurance $26.52 $26.52 Vital Signs HT WT BP P R $0.00 $0.00 Vision Titm s $26.52 $26.52 PFT W/Intery $33.66 $33.66 Aud iomet $14,28 $14.2 ECG Wl Interp $20.40 $20.40 Urinalysis Dipstick $3.06 $3.06 Bladder Cancer Screen $45.90 $45.90 Johnson Jeremy S. Comprehensive Physical $99.96 $99.96 OnMed Program $0.00 $0.00 Health Risk Appraisal Motivation 0.00 $0.00 Respirator/Medical Review $16.32 16.32 Treadmill (PFE) $156.00 $156.00 BIA Bio -Elec Im ed Anal 14.28 $14.28 Waist /Hi Ratio $3.06 $3.06 Flexibility Check $10,20 $10.2 0 Muscle rnth Endurance S26.52 $26. Vital Signs HT WT BP P R $0.00 $0.00 Vision Titmus $26.52 $26.52 PFT Whnterp $33.66 $33.66 Audiometry 14.28 $14.28 ECG W/ Interp $20.40 $20.40 Urinalysis Dipstick $3.06 $3.06 Bladder Cancer Screen $45.90 $45.90 INVOICE o Public Safety Medical Services 324 E. New York Street E Suite 300 a) al- Indianapolis, IN 46204 C Carmel Fire Department I CARMEFD 2 Civic Square Terms Carmel, IN 46032 Invoice Date 0910312010 m Invoice 00 -13561 Date Employee Description Amount Balance Due Kelsheimer. Troy W. Comprehensive Physical $99.96 99.96 OnMed Program 0.00 $0.00 Health Risk Appraisal Motivation 0.00 $0.00 Respirator/Medical Review 16.32 16.32 Treadmill (PFE $156.00 156.00 BIA Bio -Elec im ed Anal 14.28 1428 Waist /Hi Ratio $3.06 $3.06 Flexibility Check $10.20 $10.2 0 Muscle Strength Endurance S26.52 26.52 C hest PAILAT $61.20 S61 .20 tI T WT BP P Vision Titmus $26.52 $26.52 PFT W/Interp $33.66 $33.66 Audiometry 14.28 $14.28 ECG WI Interp $20.40 20.40 Urinalysis Dipstick $3.06 $3.06 Bladder Cancer Screen $45.90 $45.90 Mead Jr. Donald R. Comprehensive Physical $99.96 $99,96 OnMed Program $0.00 $0.00 Health Risk Appraisal Motivation 0.00 $0.00 Respirator/Medical Review $16.32 $16.32 Vital Signs HT WT BP P R 0.00 0.00 V Audiometry $14.28 $14.28 ECG W/ Inter $20.40 $20.40 Urinalysis Dipstick $3.06 $3.06 Bladder Cancer Screen $45.90 $45.90 Miller, Scott G. Comprehensive Physical $99.96 $99.96 OnMed Program 0.00 13.2026 Health Risk Appraisal Motivation 0.00 Respirator/Medical Review 16.32 BIA Bio -Elec Im ed Anal 14.28 Wais Hi Ratio 3.06 Flexibility Check $10.20 $10.20 Vital Sions -HT WT BP PR Vision Titmus $26.52 $26.52 PFT W/Interp $33.66 $33.66 Audiometry 14.28 $14.28 ECG W/ Interp $20.40 $20.40 Urinal sis Dipstick $3.06 3.06 Bladder Cancer Screen $45.90 $45.90 Platt Jace P. Com1preh ensive Physical $99,96 99.96 OnMed Program $0.00 $0.00 Health Risk Appraisal Motivation 0.00 $O.OD Res irator /Medical Review 1632 $16.32 Tre dmill (PFE $156.00 $156.0 INVOICE 0 Public Safety Medical Services 324 E. New York Street E Suite 300 ar w. Indianapolis, IN 46204 o Carmel Fire Department CARMEF© 2 Civic Square Terms Carmel, IN 46032 invoice Date 09/03/2010 m invoice 00 -13561 Date Employee Description Amount Balance Due BIA Bio -Elec Im ed Anal 14.28 $14.28 Waist/Hip Ratio $3.06 $3.06 Flexibility Check $10,20 $10.2 0 Musc tr n th Endurance $26.52 $26,52 Vital Signs HT WT BP P R $0.00 $0.00 Vision Titmus $26.52 $26.52 Audiometry 14.28 14.28 ECG W/ Inter 20.40 $20.4 0 Urinalysis Dipstick $3,06 $3.06 Bladder Cancer Screen $45.90 $45.90 Robinson. Mark G. CMP $19.52 $19.52 CBC W /Dill And Plat $17.68 $17.68 Li id Panel $20.74 $20.74 Veni uncture Fee $3.06 $3.06 HIV 1 2 $13.26 $13.26 P A $35.7 Spelbring, James E. Comprehensive Ph sisal $99.96 $99.96 OnMed Program $0.00 $0.00 Health Risk Appraisal Motivation 0.00 $D.00 Respirator/Medical Review 16.32 $16.32 Treadmill (PFE) $156.00 $156,00 BIA Bio -Elec Im ed Anal 14.28 $14.28 Waist/Hi Ratio $3.06 $3.06 Flexibility Check $10.20 10.20 Muscle Strength Endurance $26.52 26.52 Vital Signs HT WT BP P R $0.00 so.001 Vi ion Titmus $26. $26.52 PFT W/Interp $33.6 Audiometry $14.28 $14.28 ECG W/ Inter $20.40 $20.40 Urinalysis Dipstick 3.06 $3.06 Bladder Cancer Screen $45.90 145.90 Tierney, Scott A. Respirator/Medical Review $16.32 $16.32 Treadmill (PFE) $156.00 156.0(3 BIA Bio -Elec Im ed Anal 14.28 $14.28 Waist /Hi Ratio $3,06 $3.06 Flexibility Check $10.20 $10.2 0 Muscle Strencith Endurance $26.52 $26.52 Vital Si ns HT WT BP P R $0.00 $0.00 Vision Titmus 2 PFT W/Interp $33.66 $33.66 Audiometry $14.28 $14.28 ECG W/ Interp $20.40 $20.4 0 Urinalysis Di stick $3.06 $3.06 Bladder Cancer Screen $45.90 $45.90 Com rehensive Physical $99.96 $99.96 OnMed Program $0.00 $0.00 INVOICE 0 Public Safety Medical Services 324 E. New York Street E Suite 300 m M Indianapolis, IN 46204 C Carmel Fire Department 1 CARMEFD 2 Civic Square Terms Carmel, IN 46032 Invoice Date 09/03/2010 m Invoice 00 -13561 Date Employee Description Amount Balance Due Health Risk Appraisal Motivation 0.00 $0.00 W ant Andrew D. Comprehensive Physical $99.96 $99.96 OnMed Pro ram $0.00 $0.00 Health Risk Appraisal Motivation 0.00 $0.00 Respirator/Medical Review $16.32 $16.32 Treadmill (PFE $156.00 $156.00 BIA Bic -Elec Im ed Anal 14.28 $14.28 Waist /Hi Ratio $3.06 $3.06 Flexibility Check $10.20 $10.201 Muscle Strength Endurance $26.52 $26.52 Vi HT WT BP P 0 Vision Titmus $26.52 $26.52 PFT W/Interp $33.66 $33.66 Audiometry $14.28 $14.28 ECG W/ Interp $20,40 $20.40 Urinalysis Dipstick $3.06 $3.06 Bladder Cancer Screen $45.90 45.90 08/25110 Alverson Jonathon L. Comprehensive Physical $99.96 $99.96 OnMed Program $0.00 $0.00 Health Risk Appraisal Motivation 0.00 $0.00 Res irator /Medical Review $16.32 $16.32 Treadmill (PFE $156.00 $156.00 131 (Bi Im Anl y) $14.2B $14.2 Waist /Hi Ratio $3.06 $3.06 Flexibility Check $10.20 $10.20 Muscle Strength Endurance $26.52 $26.52 Vital SLgns HT WT BP P R $0.00 $Q.00 Vision Titmus $26.52 $26.52 PFT W/Interp $33.66 $33.66 Audiometry 14.28 $14.281 ECG W1 Intern $20.40 $20.4 0 Urinalysis Dipstick $3.06 $3.06 Bladder Cancer Screen $45.90 $45.9G Bondurant Jeff S. Comprehensive Physical $99.96 $99.96 OnMed Proorarn S0.00 Health Risk Appraisal Motivation $0.00 $0.00 Respirator/Medical Review $16.32 $16.32 Treadmill (PFE $156.00 $156.00 BIA Bio -Elec Im ed Anal 14.28 $14.28 Waist /Hi Ratio $3.06 3.06 Flexibility Check $10.20 10.20 Muscle Strencith Endurance $26.52 26.52 Chest PA/LAT $61.20 $61.20 Vital Signs HT WT BP P R $0.00 $0.00 Vision TitmLj$ $26.52 $26.52 PFT W/Interp $33.66 33.66 INVOICE o Public Safety Medical Services 324 E. New York Street E Suite 300 0 o� Indianapolis, IN 46204 o Carmel Fire Department CARMEFD I 2 Civic Square Terms Carmel, IN 46032 Invoice Date 09/03/2010 m Invoice 00 -13561 Date Employee Description Amount Balance Due Audiomet 14.28 $14.28 ECG W Inter Intero $20.40 $20.40 Urinalysis Di stick $3.06 $3.06 Bla dder C r Screen $45.90 $45. Contino. David M. Comprehensive Physical $99.96 $99.96 OnMed Program $0.00 $0.00 Health Risk Appraisal Motivation 0.00 0.00 Respirator/Medical Review $16.32 $16.32 Treadmill (PFE) $156.00 156.00 BIA Bio -Elec Im ed Anal 14.28 $14.28 Waist/Hi Ratio $3.06 $3.06 Flexibility Check $10.20 $10.2 0 Muscle Strength Endurance $26.52 $26.52 Vital Signs HT WT BP P R $0.00 $0.00 Vision Titmus $26.52 $26.52 PFT W/Interp $33,66 Audiornetry $14.28 $14.28 ECG WI Interp $20.40 $20.40 Urinalysis Dipstick $3.06 3.06 Bladder Cancer Screen $45.90 $45.90 Holden. Adam D. Comprehensive Physical $99.96 $99.96 OnMed Program $0.00 $0.00 Health Risk Appraisal Motivation 0.00 $0.00 Res frator /Medical Review $16.32 $16.32 Treadmill (PFE) $156.00 156.00 BIA Bio -EI c Imped Anal 14.28 $14.28 Waist/Hi Ratio $3.06 $3.06 Flexibility heck $10.20 S10.2 Muscle Strength Endurance $26.52 $26.52 Vital Signs HT WT BP P R $0.00 $0.00 Vision Titmus $26.52 $26,52 PFT W/Interp $33.66 $33.66 Audiomet 14.28 $14.28 ECG WI Inter 20.40 $20.40 Urinalysis Dipstick $3.06 $3.06 Bladder Cancer Screen 45.90 $45.90 Maroon Ernie R. Comprehensive Physical $gg,96 $99.96 OnMed Program $0.00 $0.00 Health Risk Aorraisal Motivation 0.00 $0.00 Resoirator/Medical Review $16.32 $1 6.32 Treadmill (PFE) $156.00 $156.00 BIA Bio -Elec Im ed Anal $14.28 $14.28 Waist/Hi Ratio $3.06 $3.06 FlexibilitV Check $10.20 1 $10.20 Muscle Strength Endurance $26.52 26.52 Vital Signs HT WT BP P R $0.00 $0.00 Vision Titmus $26.52 $26.52 INVOICE 0 Public Safety Medical Services 324 E. New York Street E Suite 300 0 W Indianapolis, IN 46204 G Carmel Fire Department! CARMEFD 2 Civic Square Terms Carmel, IN 46032 invoice Date 09/0312010 CIO Invoice 00 -13561 Date Employee Description Amount Balance Due PFT W/Interp $33.66 $33.66 Audionnetry $14.28 $14.28 ECG W/ Interp $20.40 $20.4 0 Urinalysis Dipstick $3.06 $3.06 Bladder Cancer Screen 45.90 $45.90 McNair Travis L. Comprehensive Physical S99.96 $99.96 OnMed Program $0.00 $0.00 Health Risk A raisal Motivation 0.00 $0.00 Res irator /Medical Review $16.32 $16.32 Treadmill (PFE) $156.00 $156,00 BIA Bi -El lmoed Anal y) $14,28 $14. Waist/Hi Ratio $3.06 $3.06 Flexibility Check $10.20 $10.2 0 Muscle Strength Endurance $26.52 $26.52 Vital Signs HT WT BP P R S0,00 $0.00 Vision Titmus $26.52 26 -52 PFT W/Interp $33.66 $33.66 Audiometry 14.28 $14.28 ECG W/ Interp $20.40 $20.4 0 Urinalysis Di stick $3.06 $3.06 Bladder Cancer Screen 145.90 $45. 90 Orange, Douglas D. Comprehensive Physical $99.96 $99.96 O nMed P r m Health Risk Appraisal Motivation $0.00 $0.00 Res iratorlMedical Review $16.32 $16.32 Treadmill (PFE $156.00 156.00 BIA Bio -Elec Im ed Anal 14.28 14.28 Waist/Hi Ratio 3.06 3.06 Flexibility Check 10.20 10.20 Muscle Strength Endurance 26.52 $26,52 Vital Signs HT WT BP P R $0.00 $0.00 Vision Titmus Lt 26.52 PFT W /Inter 33.66 Audiometr 14.28 CG r 4 Urinal sis Di stick $3.06 Bladder Cancer Screen $45.90 $45.90 Price. Joseph P. Comprehensive Physical $99.96 $99.96 OnMed Program $0.00 $0.00 Health Risk Appraisal Motivation 0.00 $0.00 Respirator/Medical Review $16.32 16.32 Treadmill PFE 156.00 $156.00 BIA Bio -Elec Im ed Anal 14.28 $14,28 Waist/Hi Ratio $3.06 $3.06 Flexibility Check 10.20 $10.20 Muscle Strencith Endurance $26.52 $26.52 INVOICE o Public Safety Medical Services 324 E. New York Street E Suite 300 ix Indianapolis, IN 46204 o Carmel Fire Department 1 CARMEFD H' Terms 2 Civic Square Carmel, IN 46032 Invoice Date 09/0312010 m Invoice 00 -13561 Date Employee Description Amount Balance Due Vital Si ns HT WT BP P R $0.00 $0.00 Vision Titmus $26.52 126.52 PFT Wllnter 33.66 $33.66 14,28 1 ECG W/ Interp $20.40 $20.40 Urinal sis Dipstick $3.06 $3.06 Bladder Cancer Screen $45.90 $45.90 Utzig Chad M. Com rehensive Physical $99.96 $99.96 OnMed Program 0.00 $0.00 Health Risk Appraisal Motivation 0.00 0.00 Respirator/Medical Review $16.32 $16.32 Treadmill (PFE) $156.00 $156.00 BIA Bio -Elec Im ed Anal 14.28 $14.28 WaisUHi Ratio 3.06 $3.06 Flexibility Check $10.20 $10.2 0 Musc Stre ncith Vital Signs HT WT BP P R $0.00 $0.00 Vision Titmus $26.52 $26.52 PFT W/Interp $33.66 $33.66 Audiometry $14.28 $14.28 ECG Wl Interp $20.40 $20.40 Urinal sis Dipstick $3.06 $3.06 Bladder Cancer Screen $45.90 $45.90 Watts. Trent E. Com rehensive Physical $99.96 $99.96 OnMed Program $0,00 0.00 Health Risk Appraisal Motivation 0.00 $0,00 Re iratorlMedical Review $16.32 $16.32 Treadmill (PFE) $156.00 $1 BIA Bio -Elec Im ed Anal $14.28 $14.28 Waist/Hi Ratio $3.06 $3.06 Rexibilit Check $10.20 $10.20 Muscle Strength Endurance $26.52 $26.52 Vital Signs HT WT BP P R $0.00 $0.00 Vision Titmus $26.52 $26.52 PFT W/Interp $33.66 $33.661 Audiomet 14.28 S14.28 ECG W/ Inter 20.40 $20.4 0 Urinalysis Dipstick $3.06 $3.06 Bladder Cancer Screen $45.90 $45.90 Wynn, Barbara M- Com reh n ive Physicol OnMed Program $0.00 $0.00 Health Risk Appraisal Motivation $0.00 $0.00 Respirator/Medical Review $16.32 $16.32 Treadmill (PFE $156.00 $156.00 BIA Bio -Elec Im ed Anal 14.28 $14.28 WaiSUHi Ratio $3.06 $3.06 Flexibility Check $10.20 $10.20 INVOICE f° Public Safety Medical Services 324 E. New York Street E Suite 300 Indianapolis IN 46204 A Carmel 'Fire Department CARMEFG l" 2 Civic Square Terms Carmel, IN 46032 Invoice Date 08111/2010 Invoice 00-13410 Date Emplovee Description Amount Balance Due Cromlich. Mark A. CMP $19.52 $19,52 CBC WIDiff And Plat $17.68 S 17 68 Lipid Pane€ $20.74 $20.74 Veni uncture Fee $3.06 $3.06 HIV 1 2 $13.26 513.26 PSA $35.70 35.70 Quantiferon Tb Goid 551.00 $51.00 DeCrastos. Richard A. CMP 119.52 $19.52 CBC IN /Dill And Plat $17.68 $17.68 Lipid Panel 20.74 2074 VeoiPunQtur 3.06 $3.06 HIV 1 2 $13.26 $13.26 PSA $35.70 $35.70 Quantiferon Tb Gold $51.00 $51.00 Delon Michael T. CMP $19.52 S19.52 E CBC WIDiff And Plat $17.68 $17.68 Li id Panel $20.74 $20.74 V enipuncture Pee S3.06 $3.06 HIV 1 2 $13.2e $13.26 uantiferon Tb Gold $51.00 $5 0 Edwards. Steven L. CMP S19.52 $19.52 CBC W!Diff And Plat $17.68 17.68 J[Z id Pan Q) $20.74 S20,74 Veni uncture Fee $3,06 $3.06 HIV 1 2 $13.26 $13.26 PSA $35.70 $35.70 Quantiferon Tb Gold $51.00 $51.00 Pa in. Timothv D. CMP S19.52 S19.52 CBC W /Dill And Plat S17.68 $17.68 Lipid Panel $20.74 $20.74 Veni uncture Fee $3.06 S3.06 HIV 1 2 $13.26 13.26 uantiferon Tb Gold 51.00 $51.00 Gehlbach. Marc A. Quantiferon Tb Gold $51,00 $51.00 CMP $19. $19.52 CBC W /DiffAnd Plat S17.68 $17.68 Lipid Panel 520.74 $20.74 Venipuncture Fee $3.06 $3.06 HIV 1 2 S13.26 $13.26 PSA $35.70 $35.70 Giles. William G. CMP S19.52 19.52 CBC W /Diff And Plat $17.68 $17.68 Lipid Panel $20.74 $20.74 Veni uncture Fee $3.06 3.06 HIV i 2 $13.26 $13,26 PSA $35,70 3510 INVOICE 00 Public Safety Medical Services 324 E. New York Street E Suite 300 LY Indianapolis IN 46244 0 Carmel Fire Department I CARMEFD Terms 2 Civic Square Carmel, IN 46032 Invoice Date 0811112010 Invoice 00.13410 Date Employee Description Amount Balance Due Quantiferon Tb Gold $51.00 $51 00 Gipson. Bruce E. CMP $19.52 $19.52 CBC W /Dill And Pla: $17.68 $17.68 Lipid Panel S20,74 VC 74 Veni uncture Fee $3.06 $3.06 HIV 1 2 $13.26 513.26 PSA S35.70 535.70 Quantiferon Tb Gold $51.00 $51.00 Gu el. Mark E. CMP $1952 $19.52 CBC W1Dif And Plat $17.68 $17.68 Lipid Panel $20.74 $20.74 Vent uncture Fee S3.06 $3.06 HIV 1 2 S13.26 S13.26 PSA S35.70 35.70 Q uantiferon Tb Gold S51.00 S51.0 0 Haboush. David G. CMP 19.52 $19.52 CBC W/Diff And Plat $17.68 $"17.68 Li id Panel j $20.74 $20.74 Venipuncture Fee $3.06 S3.06 HIV 1 2 $13.26 $13.26 PSA $35.70 53570 Quantiferon Tb Gold $51.00 $51.00 RBC Cholinesterase $45.90 S45.90 Hensley. Robert P. CMP $19.52 $19,52 CBC WIN' And Plat $17.68 $17,68 Li id Panel $20.74 $20.74 Veni uncture Fee S106 $3.06 HIV 1 2 $13.26 $13.26 PSA $35.70 $35.70 Quantiferon Tb Gold $51.00 551,40 Horner. David W. CMP $19.52 $19.52 CBC WlDiff, And Plat $17.68 S17.68 Lipid Panel $20.74 $20.74 Veni uncture Fee S106 S106 HIV 1 2 $13.26 $13.26 PSA $35.70 $35.70 Quantiferon Tb Gold $51.90 $51.00 Kehl. William D. CMP $19.52 $19.52 CBC W1Di And Plat $17.68 17.6 Lipid Panel 29.74 20.74 Venipuncture Fee $3.06 $3.06 HIV 1 2 $13.26 $13.26 PSA S35.70 $35.70 Quantiferon Tb Gold $51.00 $51.00 Maroon. Ernie R. CMP S19.52 $19.52 CBC W /Dif• And Plat 17.68 S17.68 Li i Panet 520.74 $20,74 INVOICE H Public: Safety Medical Services 324 E. New York Street E Suite 300 x Indianapolis, IN 46204 Carmel Fire Department I CARMEFD 2 Civic Square Terms Carmel. IN 46032 Invoice Date 08/1112010 CIO Invoice 00 -13410 Date Employee Description Amount Balance Due Venieuncture Fee S3.06 $3.06 HIV 1 2 S13.26 S13.26 PSA 535.70 $35.70 Quantiferon Tb Gold $51.00 51.00 Marsh, Michael A. Veniouncture Fee S3.06 $3.06 HIV 1 2 $13.26 1326 PSA 3570 535.70 Quantiferon Tb Gold $51.00 51.00 CMP $19.52 $19,52 CBC VV!Dif And Plat $17.68 $17.68 Li id Panel $20.7 $20.74 McNab, John D. CBC W /Dif And Plat $17.68 $17.68 Lipid $20.74 $2074 Venimncture Fee $3.06 $306 HIV 1 2 $13.26 $1326 PSA $35.70 $35.70 Quantiferon Tb Gold S51.00 $51.00 CMP $19.52 $19.52 McNair. Travis L. CMP $19.52 $19.52 CBC WlDiff And Plat $17.68 17.68 Li id Panel $20.74 S20. Vent puncture Fee 3,06 13.06 NIV 1 2 $1 2 1 .26 S11 Quantiferon Tb Gold $51.00 $51.00 HB SAb Quantitative Titer $35.70 $35.70' Mowe Anthony W. CMP $19.52 $19.52 CBC W(Diff And Plat $17.68 $17.68 Lipid Panef $2G74 $20.74 Veni uncture Fee 5106 $3.06 HIV 1 &2 S13.26 $13.26 Quantiferon Tb Gold 51.00 $51.00 Paddock. Ronald D. CMP $19.52 $19. 52 CBC W1Diff And Plat $17.68 17.68 Lod Panel 20.74 S20.74 Veni uncture Fee $3.06 HIV 1 2 $13.26 $13.26 PSA $35.70 $35.70 Quantiferon Tb Gold $51.00 $51.00 Rvan. Christopher D. CMP $19.52 $1952 CBC WIDi And Plat $17.68 $17.68 Lipid Panef S20.74 52074 Veni uncture Fee $3.06 $3.06 HIV 1 2 $13.26 $13.26 Quantiferon Tb Gold '51_00 $51.00 Smith. Brian E. CMP $19.52 519.52 CBC WiDiffAnd Plat 17 .68 17.68 INVOICE H Public Safety Medical Services 324 E. New York Stroet E Suite 300 x Indianapolis, IN 46204 o Carmel Fire Department' CARMEFD 2 Civic Square Terms Carmel. IN 46032 Invoice Date 08!1112010 m Invoice 00 -13410 Date Employee Description Amount Salance Due Lipid Panel $20.74 $20.74 Vent uncture Fee $3,06 S3.061 HIV 1 2 13.26 13.26 Q uantiferon Tb Goid S5.10 0 1. 0 Utzig, Chad M. CMP 519.52 $19.52 CBC W /DiffAnd Plat $17.68 $17.68, Li id Panel $20.74 $20.74 Veni uncture Fee $3.06 $3.06 HIV 1 2 513.26 $13.26 Quantiferon Tb Gold 551.00 $51.00 Voskuhl Mark J. CMP $19.52 $19.52 CBC W /Di+ And Plat S'7.68 $17.68 Li id Panel $20,74 $20.74 Veni uncture Fee $3.06 3.06 HIV 1 2 $13.26 $13.26 Q uantife ron T b Gold $51.00 $51.00 Webb, Grecorv,A. CMP $19.52 $19.52 CBC W /DiffAnd Plar $17.68 517.68 Lipid id Panel $20.7. 520.74 Vent uncture Fee $3.06 $3.06 KV 1 2 $13.26 $13.26 Quantiferon Tb Gold 551.00 $51.00 Young. Kevin M. CMP $19.52 $19.52 CBC W /DiffAnd Plat $17.68 $17.68 Lipid Panel 20.74 $20.74 Veni uncture Fee $3.06 $3.06 HIV 1 2 13.26 $13.26 Oua ntiferon Tb Qold 51.0 $51.0 0 Bartrom, Brad A. CMP $19.52 $19.52 CBC W /Dill And Plat $17.68 $17.68 I_r id Panel $20.74 $20.74 Veni uncture Fee $3.06 $3.061 HIV 1 &2 $13.26 $13.26 PSA $35.70 $35.70 Quantiferon Tb Gold 51.00 551.00 Cox, Justin M. CMP $19.52 $19,52 CBC WIDif And Plat $17.68 $17.68 Lipid Panel $20.7d S20.74 Vent un t ure Fee S3.06 3 06 HIV 1 2 1126 13.26 Quantiferon Tb Gold S51.00 $51.00 RBC Cholinesterase $45.90 $45.90 Eilison. Christopher M. CMP 519.52 $19.52 CBC WiDiff And Plat $17.68 $17.58 Li id Panel $20.74 $20.74 Veni uncture Fee $3.06 53.06 HIV 1 2 $13.26 $13.26 INVOI 00 Public Safety Medicai Services :t 324 E. New York Street E Suite 300 Indianapolis, IN 46204 0 Carmel Fire Department 1 CARMEFD Terms 2 Civic Square Carmel, IN 46032 Invoice Date 0811112010 m Invoice 00 -13410 Date Employee Description Amount Balance Due Quantiferon Tb Gold $51.00 $51.00 Essex. Cory C, CMP $19.52 $19.52 CBC W!DiffAnd Plat 517,68 $17.68 Livid Panel $20.74 SK 74 Veni uncture Fee $3.06 HIV 1 &2 1 $13.26 $13.26 Quantiferon Tb Gold I S51.00 $51.00 Force. Jason S. CMP $19.52 $19.52 CBC W'Diff And Plat $17.68 517.68 Lioid Panel $207A 2074 Ven re Fee $3.0 Quantiferon Tb Gold $51.00 $51.00 Freer. Keith T CMP $19.52 $19.52 CBC W /Dill And Plat $17.68 $17.68 Lipid Panel $20.74 $20.74 Veni uncture Fee $3.06 $3.06 Quanfiferon Tb Gold $51.00 551.00 Frost. Bruce S. CMP $19.52 $19.52 CBC WIDiff And Plat $17.68 $17.68 Li id Panel $20.74 $20.74 Veni uncture Fee $3.06 $3.06 HIV 1 2 $13.26 $13.26 Q uantiferon Tb Gold $51.00 S51 .00 Knott. Bruce A. CMP $19.52 $19.52 CBC WIDiff And Plat $17.68 $17.68 Lipid Panel $20.74 $20.74 Veni uncture Fee $3.06 $306 HIV 1 2 51326 513.26 °SA 535.70 $35.70 Quantiferon Tb Gold $51.00 $51_00 Maners. Jerernv S. CMP 19.52 $19.52 CBC WIDiff And Plat $17.68 $17.68 Li id Panel $20.74 520.74 V96 puncture Fee S3.06 3.0 HIV 1 2 $13.2 3 3.2 6 Quantiferon Tb Gold $51.00 $51.00 HB SAb Quantitative Titer 535.70 $35.70 Marcum. Bradley D. CMP $19.52 S19,52 CBC W /Diu And Plat $17,68 $17.68 Li id Panef $20.74 520.74 Veninuncture Fee $3.06 $3.06 Quantiferon Tb Gold $51.00 51.00 RBC Cholinesterase S45.90 $45,90 Mulford. David A. CMP $19.52 $19.52 CBC WIDi`i And Plat $17.68 $17.68 Lipid Pane! $20.74 20.74 INVOICE Q Public Safety Medical Services 324 E. New York Street E Suite 300 a) M Indianapolis, IN 46204 C Carmel Fire Department 1 CARMEFD f' Terms 2 Civic Square Carmel, IN 46032 Invoice Date 08!1112010 m Invoice r 00 -13410 Date Employee Description Amount Balance Due Veniouncture Fee $3.06 $3.06 HIV 1 2 $13.26 J1 3.26 uantiferon Tb Geld $51.00 S51.00 RBC Cholinest ra e 145.90 $4�.9 Ray, Lucas M. CMP $19.52 $19.52 CBC WOW And Plat S17.68 $17.68 Lipid Panel S20.74 520.74 Veni uncture Fee $3.06 $3.06 HIV 1 2 $13.26 13.25 Quantiferon Tb Gold $5 S51.00 Sombke, Brad D. CMP $19.52 $19.52 CBC W /Diff And Plat $17.68 $17.68 i id Panel $20.74 $20.74 Veni uncture Fee S3.06 $3.06 HIV 1 2 $13.26 $13. 26 PSA $35.70 S35.70 Quantiferon Tb Gold $51.00 $51.00 Steu Kent C. CMP $19.52 S19.52 CBC W /DiEAnd Plat 517,68 $17.68 Lioid Panel $20.74 $2074 Veni uncture Fee $3.06 $3.06 HIV 1 2 $13.26 S13.26� PSA $35.70 $35.70 Quantiferon Tb Goid S51.00 $51.0 0 Stroup Scot: .A. CMP $19,52 $19.52 CBC WIDif;` And Plat $17.68 17.68 Li id Panel 20.74 $20.74 Venipurcture Fee $3.06 $3.06 HIV 1 2 S13.26 $13.26 Quantiferon Tb Gold $51.00 551.00 Sutton, Sean B. CMP 519.52 $19.52 CBC WfDiff, And Plat $17.68 $17.68 Lipid Panel $20.74 $20.74 Veni uncture Fee 53.06 $3A6 HIV 1 2 S13.26 $13.26 PSA S35.70 $35,70 Quantiferon Tb Gold $51.00 $51.00 Thomoson. James CMP 1952 VM2 BC WDiff,An Plat $17, 8 17.6 Lipid Panel $20.74 .74 Venipuncture Fee $3.06 $3.06 HIV 1 2 513.26 $13.26 PSA $35.70 $35.70 Quantiferon Tb Gold $51.00 $51.00 Vallone. Frank CMP $19.52 $19.52 CBC W /Dili And Plat $17.68 $17.68 Lipid Panel $20.74 1 $20.74 INVOICE 0 Public Safety Medical Services I 324 E. New York Street E Suite 300 Indianapolis, IN 46204 3 Carmei Fire Department 1 CARMEFD l0 o 2 Civic Square Terms Carmel, IN 40032 Invoice Date 08/1112010 m Invoice m 00 -13410 Date Employee Descriotion Amount Balance Due Veniouncture Fee $3.06 53.06 HIV 1 2 $13.26 $13.26 PSA $35.70 $35.70 Quantiferon Tb Gold I $51.00 $51.00 Witsken. Steven J. CMP $19.52 $19.52 CBC WiDlff And Plat $17.68 $17.68 Lipid Panel $20.74 $2074 Veni uncture Fee $3.06 $3,06 HIV 1 2 13.26 $13,26 PSA $35.70 S35.70 uantiferon Tb GoE $51.00 5 Youn Andrew S. CMP $1952 $19.52 CBC WIDiSAnd Plat $17,68 $17.68 Li id Panel 52074 520.74 Veni uncture Fee $3.06 $3.06 HIV 1 2 513.26 $13.26 l Quantiferon Tb Gold $51.00 $51.00 Anderson. D. Cory CMP $19.52 $19.52 CBC W /Diff And Plat $17.68 $17,68 Lipid Panel 520.7A 520.74 Veni uncture Fee $3.06 $3.06 HIV 1 2 $13.26 $13.26 u ntifer n Tb Gold 51.00 $5 1 1.0 0 Brandt, Gary D. CMP $19.52 $19.52 CBC WlDiff And Plat $17.68 $17.68 Li id Panel $2034 520.74 Veni uncture Fee $3.06 $3.06 HIV 1 2 $13.26 513.26 PSA $35.70 $35.70 Quantiferon Tb Gold $51.00 $51 M Butts. Joseph A. CMP $19.52 519.52 CBC WlDiPf And Plat $17.68 $17,68 Lipid Panel $2C.74 $20.74 Veni uncture Fee $3.06 S3.06 HIV 1 2 S13.26 $13,26 PSA. $35.70 $35.70 Quantiferon Tb Goid $51.00 $51.00 Butts, Renee L. CMP $19.52 $1952 Cl W /Dill And Plat $17.68 $17.68 Lioid Panel $20.74 $20.74 Veni uncture Fee $3.06 $3.06 Quant €feron Tb Gold $51.00 $51.00 Condra. Kyle E. CMP 19.52 $19.52 CBC W /Diff And Plat $17,68 17.68 Lipid Panel 20.74 20.74 Veni uncture Fee $3.06 3.06 I NVOI CE H Public Safety Medical Services 324 E. New York Street E Suite 300 Indianapolis, IN 46204 c Carmel Fire Department CARMEFD I 2 Civic Square Terms Carmel, IN 46032 Invoice Date 0811112010 m Invoice 00.13410 Dp- Empievee Description Amount Balance Due HIV 1 2 $13.26 $13.26 uantiferon Tb Gold $51.00 51.00 Conner. Timothy L. CMP $19.52 $19,52 CBC WIDiff And Plat S1T68 $17.68 Li id Panel $20.74 $20.74 Veniouncture Fee $3.06 $3.06 HIV 1 2 $13.26 $13.261 PSA $35.70 $35.70 Quantiferon Tb Gold $51.00 $51.00 RBC Cholinesterase $45.90 $45.90 Deitsch. Marc W. CMP $19.52 19.52 CBC W /Diff And Plat $17.68 $17.68 Li id Panel 20.74 $20.74 Veni uncture Fee $3.06 S3.06 HIV 1 2 $13.26 $13.26 uantiferon Tb Gold $51.00 $51.0 0 Edwards, Daniel E. CMP S19.52 $19.52 CBC W /Dill And Plat $17.68 $17.68 Lipid Panel $20.74 $20.74 Veni uncture Fee S3.06 53.06 HIV 1 2 $13.26 S13.26 Quantiferon Tb Gold S51.00 S51.00 Fisher, Gary L. CMP $19.52 $19,52 CBC W /Dill And Plat $17.68 17,68 Lipid Panel $20.74 2074 Venil2uncture Fee 3.06 $3.06 HIV 1 2 1126 $13.26 P A S35.70 535.7 Quantiferon Tb Gold $51. $51.00 RBC Cholinesterase $45.90 $45.90 Harrington, Adam C. CMP $19.52 $19.52 CBC W /Dill And Plat $17.68 $17.68 Lipid Panel $20.74 $20.74 Veniouncture Fee $3.06 $3.06 HIV 1 2 $13.26 13.26 Quantiferon Tb Gold $51.00 S51.00 Miller. Scott G. CMP $19.52 $19.52 CBC W /Dill And Plat $17.68 S17.68 I i Panel $20.74 $2Q.74 Veni uncture Fee $3.00 $3.06 HIV 1 2 $13.26 $13.26 Guantiferon Tb Gold S51 00 $51.00 Payne. Thomas C. CMP $19.52 $19.52 CBC W /Diff And Plat $17.68 $17.68 Li id Panel $20.74 $20.74 Veniouncture Fee $3. $3.06 Quantiferon Tb Gold $51.00 $51.00 I INVOICE 0 Public Safety Medical Services 324 E. New York Street E Suite 300 Indianapolis, IN 46204 o Carmel Fire Department f CARMEFD f Terms f l 2 Civic Square Carmel, IN 46032 Invoice Date 08111/2010 M Invoice 00 -13410 bate Employee Description Amount Balance Due Plumer. Charles J. CMP $19.52 $19.52 CBC W /Diff And Plat $17.66 $17.68 Lipid Panel $20.74 $20.74 Veni uncture Fee 53.06 $3.06 HIV 1 2 $13.26 $13.26 PSA $35.70 $35.70 Quantiferon Tb Gcid s5i.on $51.00 RBC Cholinesterase $45.90 $45.90 Reecer. Jason L. CMP $19.52 $19.52 CBC W /Diff And Plat $17.68 $17.68 Lipid Panel $20.74 $20.74 Veni uncture Fee $3.06 S3.06 I HIV 1 &2 $13.26 $13.261 Quantiferon Tb Gold $51.00 S51.00 RBC Cholinesterase $45.90 $45.90 Reeves. Neil P. CMP S19.52 $19.52 CBC W /Diff And Plat $17.68 $17.68 Lipid Panel 520.74 520.74 Veni uncture Fee $3.06 53.06 HIV 1 2 $13.26 $13.26 RBC Cholinesterase 45.90 $45.90 Q uantiferon Tb Gold $5 $5 1 1.0 0 Reeves. Ste hen J. MP 519.5 19. 2 CBC WlDiffAnd Plat $17.68 S17.68 Li id Panel S20.74 $20.74 Veni uncture Fee $306 $106 HIV 1 2 $13.26 $13.26 PISA 535.70 535.70 Quantiferon Tb Gold 551.00 '51.00 Rohr. Christopher M. CMP $19,52 $19.52 CBC W /DifrAnd Plat S17,68 $17.68 Lipid Panel 520.74 $20.74 Veni uncture Fee "3.06 $3.06 HIV 1 2 S 13 2 $13.25 Q uantiferon Tb Gold $51.00 $51.00 Thordarson. Erik M. CMP 19.52 $19.52 CBC W(Diff And Plat 517.68 $17.68 Lipid Panel $20.74 520.74 Veni uncture Fee $3.06 S3.06 HlV 1 2 $13.26 $13.26 Quanfiferon Tb Gold $51.00 $51.00 Tiernev. Scott A. CMP S19.52 19.52 CBC W /Dif,` And Plat $17.68 $17.6B Li id Panel $20,74 $20.74 Veni uncture Fee 3.06 $3,06 HIV 1 2 13.26 13.26 I I VOUCHER NO. WARRANT NO. ALLOWED 20 Public Safety Medical Services IN SUM OF 324 East New York Street, Ste. 300 Indianapolis, IN 46204 $64,648.94 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO# Dept. INVOICE NO. ACCT #!TITLE AMOUNT Board Members 1120 10 -10228 43- 407.01 ($7,344.0 1 hereby certify that the attached invoice(s) or 1 120 13410 43- 407.01 $9,756.3 6. bill(s) is (are) true and correct and that the 6028 1120 13600 43- 407.01 $16,. materials or services itemized thereon for 1120 13561 43- 407.01 $17,072.56 1120 13513 43- 407.01 $23 ,293.72 which charge is made were ordered and 1120 13647 43- 407.01 $5,267.44 received except SEP f7 2010 !7 Fire Chief Title Cost distribution ledger classification if claim paid motor vehicle highway fund Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995) ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL 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. Payee Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 10 -10228 O`er Q ($7,344.00) 13410 $9,756.36 13600 $16,602.86 13561 $17,072.56 13513 $23,293.72 13647 $5,267.44 1 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 Clerk- Treasurer