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Home My WebLink About223032 08/13/2013 CITY OF CARMEL, INDIANA VENDOR: 367222 Page 1 of 1 `4 ONE CIVIC SQUARE IU HEALTH WORKPLACE SERVICES LLc CARMEL, INDIANA 46032 2046 RELIABLE PKWY CHECK AMOUNT: $35,371.80 CHICAGO IL 60686-0020 CHECK NUMBER: 223032 CHECK DATE: 8/13/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 301 5023990 731243 29, 370 . 00 OTHER EXPENSES 301 5023990 731288 1, 597 . 64 OTHER EXPENSES 1201 4358800 731296 30 . 00 TESTING FEES 301 5023990 731347 4, 374 . 16 OTHER EXPENSES Indiana University Health Workplace Services, LLC 4850 W.Century Plaza Rd. WP-City of Carmel Indianapolis, IN 46254-5477 317-216-2828 Tax I D# 20-0994452 Invoice August 1, 2013 Bill to: Barbara Lamb For: City of Carmel- Onsite City of Carmel-Onsite Onsite/July 2013 1 Civic Square Carmel,IN 46032- Invoice# 731296 Proc Code Service Date Description Quantit Charge Receir) AAWust Balance 07/17/2013 Quick Read UDS/6panel includes 1.00 15.00 15.00 kit 30.00 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK D Q AUG 12 2013 , By VOUCHER NO. WARRANT NO. ALLOWED 20 IU Health Workplace Services, LLC IN SUM OF$ 2046 Reliable Pkwy Chicago, IL 60686-0020 $30.00 ON ACCOUNT OF APPROPRIATION FOR Carmel HR Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 12_01 l 731296 I 43-588.00 I $30.00 I hereby certify that the attached invoice(s), or 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 Monday, August 12, 2013 Director, HR 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)) 08/01/13 731296 $30.00 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 5-11-10-1.6 120 Clerk-Treasurer Indiana University Health Workplace Services,LLC 4850 W. Century Plaza Rd. ') WP-City of Carmel Indianapolis, IN 46254-5477 317-216-2828 Tax I D# 20-0994452 Invoice August 1, 2013 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Nurse Time/July 2013 1 Civic Square Carmel,IN 46032- Invoice# 731243 Proc Code Service Date Descriptio Quanti Charge Receipt Adjust Balance 07/01/2013 CONTRACT R.N.DAY 5.00 875.00 875.00 Dr.Fagan 07/01/2013 CONTRACT R.N.DAY 5.00 310.00 310.00 Gwen Kopecky 07/01/2013 CONTRACT R.N.DAY 5.00 140.00 140.00 Jennifer Lawson 07/02/2013 CONTRACT R.N.DAY 6.00 1,050.00 1050.00 Dr.Fagan 07/02/2013 CONTRACT R.N.DAY 6.00 372.00 372.00 Gwen Kopecky 07/02/2013 CONTRACT R.N.DAY 6.00 168.00 168.00 Jennifer Lawson 07/03/2013 CONTRACT R.N.DAY 5.00 875.00 875.00 Dr.Nadelson 07/03/2013 CONTRACT R.N.DAY 5.00 140.00 140.00 Jennifer Lawson 07/03/2013 CONTRACT R.N.DAY 5.00 310.00 310.00 Dorothy Goen 07/05/2013 CONTRACT R.N.DAY 5.00 875.00 875.00 Dr. Gutwein 07/05/2013 CONTRACT R.N.DAY 5.00 140.00 140.00 Jennifer Lawson 07/08/2013 CONTRACT R.N.DAY 5.00 875.00 875.00 Dr.Fagan 07/08/2013 CONTRACT R.N.DAY 5.00 310.00 310.00 Gwen Kopecky 07/08/2013 CONTRACT R.N.DAY 5.00 140.00 140.00 Jennifer Lawson 07/09/2013 CONTRACT R.N.DAY 6.00 1,050.00 1050.00 Dr.Fagan 07/09/2013 CONTRACT R.N.DAY 6.00 372.00 372.00 Gwen Kopecky Invoice# 731243 (continued)page 2 Proc Code Service Date Description Quanti Charge Receip Adiust Balance 07/09/2013 CONTRACT R.N.DAY 6.00 168.00 168.00 Jennifer Lawson 07/10/2013 CONTRACT R.N.DAY 5.00 875.00 875.00 Dr.Fagan 07/10/2013 CONTRACT R.N.DAY 5.00 310.00 310.00 Gwen Kopecky 07/10/2013 CONTRACT R.N.DAY 5.00 140.00 140.00 Jennifer Lawson 07/11/2013 CONTRACT R.N.DAY 4.00 700.00 700.00 Dr.Fagan 07/11/2013 CONTRACT R.N.DAY 4.00 248.00 248.00 Gwen Kopecky 07/11/2013 CONTRACT R.N.DAY 4.00 112.00 112.00 Jennifer Lawson 07/12/2013 CONTRACT R.N.DAY 5.00 875.00 875.00 Dr.Fagan 07/12/2013 CONTRACT R.N.DAY 5.00 310.00 310.00 Gwen Kopecky 07/12/2013 CONTRACT R.N.DAY 5.00 140.00 140.00 Jennifer Lawson 07/15/2013 CONTRACT R.N.DAY 5.00 875.00 875.00 Dr.Fagan 07/15/2013 CONTRACT R.N.DAY 5.00 140.00 140.00 Jennifer Lawson 07/15/2013 CONTRACT R.N.DAY 5.00 310.00 310.00 Gwen Kopecky 07/16/2013 CONTRACT R.N.DAY 6.00 1,050.00 1050.00 Dr.Fagan 07/16/2013 CONTRACT R.N.DAY 6.00 168.00 168.00 Jennifer Lawson 07/16/2013 CONTRACT R.N.DAY 6.00 372.00 372.00 Gwen Kopecky 07/17/2013 CONTRACT R.N.DAY 5.00 875.00 875.00 Dr.Fagan 07/17/2013 CONTRACT R.N.DAY 5.00 140.00 140.00 Jennifer Lawson 07/17/2013 CONTRACT R.N.DAY 5.00 310.00 310.00 Gwen Kopecky 07/18/2013 CONTRACT R.N.DAY 4.00 700.00 700.00 Dr.Fagan 07/18/2013 CONTRACT R.N.DAY 4.00 112.00 112.00 Jennifer Lawson 07/18/2013 CONTRACT R.N.DAY 4.00 248.00 248.00 Gwen Kopecky 07/19/2013 CONTRACT R.N.DAY 5.00 875.00 875.00 Dr.Fagan 07/19/2013 CONTRACT R.N.DAY 5.00 140.00 140.00 Jennifer Lawson Invoice# 731243 (continued)page 3 Proc Code Service Date Description uanti Charge Receiut AM-u-sl Balance 07/19/2013 CONTRACT R.N.DAY 5.00 310.00 310.00 Gwen Kopecky 07/22/2013 CONTRACT R.N.DAY 5.00 875.00 875.00 Dr.Fagan 07/22/2013 CONTRACT R.N.DAY 5.00 140.00 140.00 Jennifer Lawson 07/22/2013 CONTRACT R.N.DAY 5.00 310.00 310.00 Gwen Kopecky 07/23/2013 CONTRACT R.N.DAY 6.00 1,050.00 1050.00 Dr.Fagan 07/23/2013 CONTRACT R.N.DAY 6.00 168.00 168.00 Jennifer Lawson 07/23/2013 CONTRACT R.N.DAY 6.00 372.00 372.00 Gwen Kopecky 07/24/2013 CONTRACT R.N.DAY 5.00 875.00 875.00 Dr.Fagan 07/24/2013 CONTRACT R.N.DAY 5.00 140.00 140.00 Jennifer Lawson 07/24/2013 CONTRACT R.N.DAY 5.00 310.00 310.00 Gwen Kopecky 07/25/2013 CONTRACT R.N.DAY 4.00 700.00 700.00 Dr.Fagan 07/25/2013 CONTRACT R.N.DAY 4.00 112.00 112.00 Jennifer Lawson 07/25/2013 CONTRACT R.N.DAY 4.00 248.00 248.00 Gwen Kopecky 07/26/2013 CONTRACT R.N.DAY 5.00 875.00 875.00 Dr.Fagan 07/26/2013 CONTRACT R.N.DAY 5.00 140.00 140.00 Jennifer Lawson 07/26/2013 CONTRACT R.N.DAY 5.00 310.00 310.00 Gwen Kopecky 07/29/2013 CONTRACT R.N.DAY 5.00 875.00 875.00 Dr.Fagan 07/29/2013 CONTRACT R.N.DAY 5.00 140.00 140.00 Jennifer Lawson 07/29/2013 CONTRACT R.N.DAY 5.00 310.00 310.00 Gwen Kopecky 07/30/2013 CONTRACT R.N.DAY 6.00 1,050.00 1050.00 Dr.Fagan 07/30/2013 CONTRACT R.N.DAY 6.00 168.00 168.00 Jennifer Lawson 07/30/2013 CONTRACT R.N.DAY 6.00 372.00 372.00 Gwen Kopecky 07/31/2013 CONTRACT R.N.DAY 5.00 875.00 875.00 Dr.Fagan 07/31/2013 CONTRACT R.N.DAY 5.00 140.00 140.00 Jennifer Lawson Invoice# 731243 (continued)page 4 Proc Code Service Date Description Quantit Charge Receipt Ad ust Balance 07/31/2013 CONTRACT R.N.DAY 5.00 310.00 310.00 Gwen Kopecky CITYCARO Invoice# 731243 Balance Due: 29370.00 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK - Cut ml etum with payment Indiana University Health Workplace Services, LLC 4850 W. Century Plaza Rd. WP-City of Carmel Indianapolis, IN 46254-5477 317-216-2828 1 Tax ID# 20-0994452 Invoice August 1, 2013 Bill to: Barbara Lamb For: City of Carmel-Onsite City of Carmel-Onsite Misc.Onsite/July 2013 1 Civic Square Carmel,IN 46032- Invoice# 731288 Proc Code Service Date Descriotio Quanti Charge Receip Adjust Balance 99070 06/23/2013 Young at Heart Clinic Meds 1.00 634.12 634.12 99070 06/30/2013 Young at Heart Clinic Meds 1.00 66.34 66.34 99070 07/01/2013 Onsite Lab Charges 1.00 495.48 495.48 99070 07/07/2013 Young at Heart Clinic Meds 1.00 288.16 288.16 99070 07/21/2013 Young at Heart Clinic Meds 1.00 113.54 113.54 CITYCARO Invoice# 731288 Balance Due: 1597.64 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK mss,,,,,, r,r ani rrh with�avment Indiana University Health Workplace Services, LLC 4850 W. Century Plaza Rd. WP-City of Carmel °) Indianapolis, IN 46254-5477 �--- 317-216-2828 Tax I D# 20-0994452 Invoice August 1, 2013 Bill to: Barbara Lamb For: City of Carmel- Onsite City of Carmel- Onsite Onsite Fees/July 2013 1 Civic Square Carmel,IN 46032- Invoice# 731347 Proc Code Service Date Descriptio Quanti Charge Receipt Adjust Balance CARMBUIL 07/01/2013 City of Carmel Clinic Build Out 1.00 2,574.16 2574.16 CARMLEAS 07/01/2013 City of Cannel Sports Performance 1.00 1,800.00 1800.00 Lease CITYCARO Invoice# 731347 Balance Due: 4374.16 MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE INVOICE#ON CHECK �_� Cut and return with paZment 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 IU Health Workplace Services, LLC Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) Total 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 NOI—WARRANT NO. ALLOWED 20 111 Health Wnrknlace Service-, LLC IN SUM OF $ —2046 Reliable Pkwy 11 60666-0020 $ 35,341 .8-0 ON ACCOUNT OF APPROPRIATION FOR 301 Medi .al Rind Board Members PO#or INVOICE NO. ACCT#/TITLE AMOUNT DEPT.# I hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and that the 731243 $29,370.00 materials or services itemized thereon for which charge is made were ordered and received except 20 Acl,-�� Signature Title Cost distribution ledger classification if claim paid motor vehicle highway fund