The URL can be used to link to this page

Home My WebLink About164892 10/16/2008 CITY OF CARMEL, INDIANA VENDOR: 00350364 Page 1 of 1 ONE CIVIC SQUARE PUBLIC SAFETY MEDICAL SERVICES io CARMEL, INDIANA 46032 324 E NEWYORK ST SUITE 300 CHECK AMOUNT: $1,686.00 INDIANAPOLIS IN 46204 CHECK NUMBER: 164892 ro„ i CHECK DATE: 10/16/2008 D EPARTMENT A CCOUNT. PO NUMBER INVOI NUMBER AMOUNT DESCRIPTION 1120 4340701 9932 245'.00 MEDICAL EXAM FEES 3110 4340701 9933 416.00 MEDICAL EXAM FEES 1120 4340702 9967 240.00 SHOTS INOCULATIONS 1110 43407.01 9968 785.00 MEDICAL EXAM FEES x s w INVOICE o' Public Safety Medical Services 324 E. New York Street :E Suite 300 Ix;: Indianapolis, IN 46204 ..O Carmel Police Department I CARMEPD 3 Civic Square Terms Carmel, IN 46032 Invoice Date 09/30/2008 Invoice 00 -09933 Date ,Employee Description Amount Balance Due 09/22/08 Collins, Larry J. 10 Cities $234.00 $234.00 OnMed Program 10.00 $10.0 0 Treadmill (PFE) $165.00 $165.DO Flexibility Check $7.00 $7.00 Waist/Hi Ratio $0.00 0.00 TotalCharges _n $416:00 TotaGPayments &;Balance -due $0;00 :$4fi6:OQ Please write invoice number on payment check. Our Federal Employer Identification Number is 35- 2079797 INVOICE Public Safety Medical Services 324 E. New York Street E'• Suite 300 Indianapolis, IN 46204 Carmel Police Department! CARMEPD 3 Civic Square Terms Invoice Date 10/08/2008 Carmel, IN 46032 Invoice 00 -09968 r Date N Employee s. Description Amount Salance.Due 09/29!08 Henr David R. Quantiferon Tb Gold $50.00 $50.00 Exec 1 Wellness Offsite $61.00 $61.00 RSA $36.00 $36.00 10101108 Case. Todd L. Exec 1 Wellness 61.00 $61,00 HIV 1 2 $0.00 0.00 Quantiferon Tb Gold 50.00 $50.0 0 Smith, Troy D. 10 Cities $234.00 $234,00 Treadmill (PFE) $165.00 $165.00 Flexibility Check $7.00 $7.00 Waist/Hi Ratio $0.00 $0.00 O nMed Program 1 10/03108 Kin on, David M. Exec 1 Wellness $61.00 $61.00 HIV 1 &2 $0.00 $0.00 Quantiferon Tb Gold $50.00 $50.00 Total Charges $785:00 Total Pa ments` &Balance Due $0:00 $785:00 Please write invoice number on payment check. Our Federal Employer Identification Number is 35- 2079797 Balance due 15 days from invoice date. Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995) 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 300 Terms Indianapolis, IN 46204 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 9/30/08 9933 payment for officer physicals 416.00 10/8/08 9968 paymwnt for officer physicals 785.00 Total 201.00 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. ALLOWED 20 Public Safety Medical Services IN SUM OF 324 E. New York Street, Suite 300 Indianapolis, IN 46204 1,201.00 ON ACCOUNT OF APPROPRIATION FOR pali ce b a rpia fund Board Members PO# or INVOICE NO. ACCT #/TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or 1110 9933 407 -01 416.00 bill(s) is (are) true and correct and that the 1110 9968 407 -01 785.00 materials or services itemized thereon for which charge is made were ordered and received except October 10 20 08 D Signature Chief of yOlice Cost distribution ledger classification if Title claim paid motor vehicle highway fund INVOICE Public Safety Medical Services 324 E. New York Street -�E Suite 300 m Indianapolis, IN 46204 Carmel Fire Department CARMEFD .o Terms 2 Civic Square Invoice Date 09/3012008 Carmel, IN 46032 Invoice 00-09932 -Description 'Balanr-e Due 09/22108 Stindle, Kevin P. Repeat Chest X-Ray $0.00 $000 Thompson, James L. Fitness For Duty Level 11 $175M $175.00 Drug Screen (8) GUMS W/MRO $70.00 $70,00 Total Charges' Please write invoice number on payment check. Our Federal Employer Identification Number is35'2O7O787 INVOICE i2.' Public Safety Medical Services .r. 324 E. New York Street E Suite 300 tr, Indianapolis, IN 46204 Carmel Fire Department 1 CARMEFD 2 Civic Square Terms Carmel, IN 46032 Invoice Date 10/08/2008 m Invoice 00 -09967 Date=.. Employee Description Amount; :Balancebue: 09129/08 Gipson, Bruce E. No -Show Fee $0.00 $0.00 09/30108 Frost, Bruce S. Repeat Chest X -Ray N/C) $0.00 $0,00 10/01/08 Ray, Lucas M. Hepatitis B Vaccination #1 $70.00 $70.0 0 Injection Fee $10.00 $10.0 0 Watts Trent E. He atitis B Vaccination #1 $70.00 70.00 In'ection Fee $10,00 $10.00 Woodburn Scott E. Hepatitis B Vaccination #1 170.00 $70.00 In'ection Fee $10.00 $10,00 TotaLCf a es $240 ^00 ",Total Payments 8'.Belance`Due 00• Please write invoice number on payment check. Our Federal Employer Identification Number is 35- 2079797 Balance due 15 days from invoice date. VO NO. WARRANT NO. ALLOWED 20 Public Safety Medical Services IN SUM OF 324 East New York Street, Ste. 300 Indianapolis, IN 46204 $485.00 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO# Dept. INVOICE NO. ACCT #!TITLE AMOUNT Board Members 1120 9967 43- 407.02 $240.00 1 hereby certify that the attached invoice(s), or 1120 9932 43- 407.01 $245.00 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 OCT 19 2008 z� n d 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)) 9967 Shots $240.00 9932 Exams $245.00 I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accordance with IC 5- 11- 10 -1.6 20 Clerk- Treasurer