KEYSTONE ORTHOPEDIC SPECIALISTS S.C. 

835 HUTCHISON RD 

FLOSSMOOR IL 60422-1317 

Statement of Account 

Last statement: June 29, 2018 

This statement: JulJ 31, 2018 

1283 Page 1 of3 

Direct inquiries to: 

Customer Service 

800-322-3623 

408 

First Midwest Bank 332 

18600 Dixie Highway 

Homewood, Illinois 60430 

Summary of Account Balance 

I 

l::::::c Business Checking 1283 

Number 

I Strategic Business Checking 

Account number 

283 Beginning balance $38,274.09 

Average balance $24,853.55 

32 Enclosures Total additions $52,788.91 Total subtractions 

Number Date Amount 

16241 07-05 150.00 

16286. 07-02 500.00 

16289. 07-03 54.16 

16297' 07-03 316.85 

16298 07-06 5.96 

16299 07-03 52.11 

16300 07-09 10.40 

16301 07-05 566.19 ... r='')rt') n7 -in -t'J"1 a7 IV.JUL Uf -1;;:;1 l..J I.VI 

16303 07-02 25,000.00 

16304 07-23 200.09 

16305 07-23 61.88 

16306 07-27 215.66 

16307 07-20 105.00 

16308 07-20 126.99 

16309 07-20 585.00 

16310 07-30 36.79 

16311 07-23 120.00 

16313. 07-23 105.50 -"~""A JI r>."'7 '"lo~ ,,., ..,.,..,.., ...,,,., IUJI"+ Uf-L-.J J,l<:JL.LJ 

16318. 07-31 316.58 

16319 07-31 13.61 

16321 • 07-31 157.55 

" Skip in check sequence 

32 

I 

Ending Balance I 

$33,131.37 ! 

$-57,931.63 

Control 

000005704838610 

000003869078860 

000008634125910 

000003871515570 

000008637490470 

000003871514250 

000008637664590 

000008635928030 

nnnnn'l ooo'"lnn'l -t n UVUVV.JUUULU;::IJ IV 

000005703061620 

000003891216950 

000008652321220 

000003895876490 

000008651405020 

000008652181330 

000003888843370 

000008660799870 

000003891131900 

000003891208720 

r.n.n.r.n.o~~~0"'7r.A~f'o UUUUUOUJUO/;:;JIUU 

000008662597960 

000008662600280 

000003899105280 

Case: 1:12-cv-05836 Document #: 568-2 Filed: 10/17/18 Page 1 of 2 PageID #:14878
KEYSTONE ORTHOPEDIC SPECIALISTS S.C. 

835 HUTCHISON RD 

FLOSSMOOR IL 60422-1317 

Statement of Account 

Last statement: June 29, 2018 

This statement: JulJ 31, 2018 

1130 Page 1of4 

Direct inquiries to: 

Customer Service 

800-322-3623 

408 

First Midwest Bank 332 

18600 Dixie Highway 

Homewood, Illinois 60430 

Summary of Account Balance 

I 

l::::::c Business Checking 

I Strategic Business Checking 

Account number 

1130 Beginning balance 

Average balance 

Total additions 

$41.89 

$2,954.62 

$28,647.06 

Number 

1130 

Total subtractions 

0 

I 

Ending Balance I 

$3,286.04 ! 

$-25,402.91 

~D•~t~e __ D~•~•~c~rip~u~·o~n __________ ~C~o~nt~ro~l~n~um=be~r ____ ~A~d~d~it~io~n~s ____ s~u=btractions 

07-02 #Preauthorized Credit 242071753321414 1,981.11 

Merch Bankcard Comb. Dep. 

Merch Bankcard Comb. Dep. Ter 

M 520000164101005 Batch 0000017 

07-03 #Preauthorized Credit 042000011005863 

Ngs, Inc. Hcclaimpmt 

893325280'1351840597-

07-03 #Preauthorized Credit 071000158798378 

Bcbs Illinois Hcclain1pn1t 

T18183E02634550'1731350270"T18183E02 

634550-15280205591 

07-03 #Preauthorized Credit 

36 Treas 310 Misc Pay 

180703 363926845360012 

07-03 #Preauthorized Credit 

P8lmetto Gba Hcclaimpmt 

803052784'1571062326-

07-03 #Preauthorized Credit 

Mapd Bcbs Hcclarmpmt 

101036150421210 

031100204317304 

071000158418409 

ivi18183E02493190'"1731350270*ivi18183E02 

493190-15280205591 

583.90 

106.41 

41.23 

39.20 

28.01 

Case: 1:12-cv-05836 Document #: 568-2 Filed: 10/17/18 Page 2 of 2 PageID #:14879