The URL can be used to link to this page

Home My WebLink About159038 04/30/2008 CITY OF CARMEL, INDIANA VENDOR: 00350364 Page 1 of 1 ONE CIVIC SQUARE PUBLIC SAFETY MEDICAL SERVICES o CARMEL, INDIANA 46032 324 E NEW YORK ST SUITE 300 CHECK AMOUNT: $2,006.00 INDIANAPOLIS IN 46204 CHECK NUMBER: 159038 CHECK DATE: 4/30/2008 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1110 4340701 9047 416.00 MEDICAL EXAM FEES 1110 4340701 9080 1,590.00 MEDICAL EXAM FEES I INVOICE 0 Public Safety Medical Services 324 E. New York Street E Suite 300 X Indianapolis, IN 46204 o Carmel Police Department CARMEPD 3 Civic Square Terms m Carmel, IN 46032 Invoice Date 04/15/2008 Invoice 00 -09047 Date Employee Description Amount -Balance Due' 04/09/08 Collins Shane P. 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 OnMed Program 10.00 10.00 Total Charges $416:00 Total Payments Balance Due 30.00 :$416.00_ Please write invoice number on payment check. Our Federal Employer Identification Number is 35- 2079797 INVOICE o Public Safety Medical Services 324 E. New York. Street Suite 300 Indianapolis, IN 46204 Carmel Police Department CARMEPD 3 Civic Square Terms Carmel, IN 46032 Invoice Date 0412412008 Invoice 00 -09080 €Employee' rz: m:= Descnptron i:e b fiRmourit ;;Balance Due' 04/17/08 Anderson. Teresa K. Quantiferon Tb Gold $50.00 $50.00 Bailey Vicki L. Quantiferon Tb Gold $50.00 $50.00 Bell, Susan M. Quantiferon Tb Gold $50.00 $50.00 Boles Elizabeth L. Quantiferon Tb Gold $50.00 $50.00 Cavanaugh, Julie Quantiferon Tb Gold $50.00 $50.00 Dawson Gregory F. Exec 1 Wellness Offsite $61.00 $61.00 Quantiferon Tb Gold $50.00 $50.00 DeLong, Kdstv A. Quantiferon Tb Gold $50.00 $50.00 Dietz Aaron K. Exec 1 Wellness Offsite $61.00 $61,00 HIV $0.00 $0.00 an if r n Tb Gold 0 Doan, Marie L. Quantiferon Tb Gold $50.00 $50.00 Gallo her Ann Quantiferon Tb Gold $50.00 $50.00 Jable, Patricia A. Quantiferon Tb Gold $50.00 50.00 Jent Danny N. Exec 1 Wellness Offsite $61.00 $61.00 HIV $0.00 0.00 Quantiferon Tb Gold $50.00 50.00 Mulligan, Laura J. Quantiferon Tb Gold $50,00 $50.00 Hepatitis B Vaccination #1 $70.00 $70.0 0 hection Fee $10,00 $10.00 Pratt Kimberly K. Exec 1 Wellness Offsite $61.00 $61.0 0 HIV $0,00 $0.00 n'f r n -T Ross, Linda L. Quantiferon Tb Gold $50.00 $50.00 Thurston Luann Quantiferon Tb Gold $50.00 50.00 Young Patricia A. Quantiferon Tb Gold $50.00 $50.0 0 04/18/08 Strong, David C. 10 Cities $234.00 $234.00 Treadmill (PFE) $165.00 $165.00 Flexibilitv Check $7.00 $7.00 Waist/HiD Ratio sago 0.00 OnMed Program 10.00 10.00 '.as f✓ y 4 R S n `f�'cd�.k. i4 p,�t,fa °z. €a.., x�'''s i7 u "L 3;„ 1 TdfaLCharges f x$,:00 ra a gotal:Payments,B:Balance °D'u'e $t 590.003 Please write invoice number on payment check. Our Federal Employer Identification Number is 35- 2079797 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 i' 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)) 4/15/08,9047 a ent for officer physicals 416.00 4/24/08 9080 payment for officer physicals and civilian TB tests 1,590.00 1,590 Total 2,006.00 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. 1 ALLOWED 20 P ublic Safety Medical Services IN SUM OF 324 E. New York Street, Suite 300 Indianapolis, IN 46204 2,006.00 ON ACCOUNT OF APPROPRIATION FOR police general fund Board Members PO# or INVOICE NO. ACCT #!TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or 1110 9047 407 -01 416.00 bill(s) is (are) true and correct and that the 1110 9080 407 -01 1,590.00 materials or services itemized thereon for which charge is made were ordered and received except April 24 20 08 b- -/e r� Signature Chief of POlice Cost distribution ledger classification if Title claim paid motor vehicle highway fund