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Home My WebLink About234401 07/01/14 W RAA MFS CITY OF CARMEL, INDIANA VENDOR: 360209 ONE CIVIC SQUARE ST VINCENT HOSPITAL CHECK AMOUNT: $***"1,879.29• ?q CARMEL, INDIANA 46032 ATTN:CAROLYN TERRY,ACCT REPTNG CHECK NUMBER: 234401 y...,_ 10330 N MERIDIAN ST SUITE 430 CHECK DATE: 07/01114 INDIANAPOLIS IN 46290 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 102 4239011 13406 1,879.29 SPECIAL DEPT SUPPLIES St. Vincent Hospital&Healthcare Center, Invoice T-- Attn: Carolyn Terry,Acct Rptg 10330 N.Meridian St., Suite 430 North DATE INVOICE# Indianapolis, IN 46290-1024 6/26/2014 13406 BILL TO Carmel Fire EMS Attn: Accounts Payable 2 Carmel Civic Square Carmel,INA6032 TERMS Due on receipt DESCRIPTION AMOUNT EMS Supplies purchased May 2014 1,879.29 Medical Supplies $834.89 Transfer Drugs 1,044.40 Total Due: $1,879.29 46029-160085-65050. Please note invoice number Total $1,879.29 that you are paying on check/stub. Thank you! Inquiries: Carolyn Terry Payments/Credits $0.00 317.583.3301 cmterry@stvincent.org Balance Due $19879.29 Depatmental Transfer of Supplies date submissed 06/01/14 Requesting Department: Carmel Fire Dept Supplying Department ER Cost Center 8213 Cost Center 27230 ITEM# I QUANTITY UNIT COST TOTAL COST Alcohol preps 9219 $2.67 $0.00 Angiocath 18g 1266 35 $1.50 $52.50 Angiocath 20g 1264 56 $1.50 $84.00 An icoath 209 1.16 box 2 $78.50 $157.00 Angiocath 22g 1262 20 $1.50 $30.00 Angiocath 24g 12611 $1.55 $0.00 Basin kidney shaped 10302 $0.08 $0.00 Basin round 10297 $0.31 $0.00 Coban 1' Roll(ea) 39 $1.75 $0.00 Cold paks 45779 6 $0.57 $3.42 EKG Electrodes 72104 6 $3.12 $18.72 Emesis Bas(per pack) 1189841 $11.52 $0.00 Guaze,2 x 2 Cotton bail 9170 6 $1.88 $11.28 Gauze Kerlex 9217 3 0.671 $2.01 Gloves-Med - 985 2 $5.411 $10.82 Gloves-Large 986 1 5.411 $5.41 Gloves-Marge 34059 4 5.961 $23.80 IV Adapter, Luerlock 12601 5. 0.151 $0.75 IV Dial a flow 17477 $3.15 $0.00 IV Extension 19" 1223 $1.91 $0.00 IV Lock with Ext 1221 35 $1.87 $65.45 IV Start Kits 100/bx 78663 60 $1.00 $60.00 IV Start Kits Sobraview(100/bx) 116570 44 $2.66 $117.04 IV Tubing 15 tt 486 - 21 $1.17 $24.57 Kerlix 4.5"x6ply 201627 $0.73 $0.00 Microdot Xtra Test Strips $24.95 $0.00 Microdot Xtra Control Solutions $12.00 $0.00 Normal Saline 1000 cc bags/ca 446 $9.48 $0.00 Razor, disposeable 9101 0.12 $0.00 Sca el#11 LUM1948 1.301 0.00 Sharps Container 23636 $4.59 $0.00 Sterile H2O bottle 384 $0.71 $0.00 Suction Canister&top 3634 1 $3.261 $3.26 Suture Kit 1 $1.09 $0.00 Syringe w/Needle 1 ml 2028 $0.07 $0.00 Syringe w/Needle 3 ml 2014 20 $0.05 $1.00 S ringe w/Needle 5ml 2030 $0.10 $0.00 S rin a w/Needle 10 ml 2031 15 $0.12 -- $1:80 S rin e w Saline 3ml 105371 $0.28 $0.00 Syringe w/Saline10ml 37350 40 $0.32 $12.80 30 ml saline vials(per box) 330 2 $9.63 $19.26 Tape 2" 6 rolls/box 159 $1.00 $0.00 Tae 1" 158 $0.50 $0.00 Tape 2"cloth adh 181 $1.29 $0.00 Tape Trans ore 1/2" $1.28 $0.00 Warm paks 3416 $1.46 $0.00 Wound Cleanser 17344 $5.04 $0.00 Suction Canister&top 3634 $3.26 $0.00 Yankauers 9377 $0.34 $0.00 Ambu Ba w/mask-Adult 18696 $8.60 $0.00 Ambu Ba w/mask-Peds 37012 $15.00 $0.00 Ambu Ba w/mask-Infant cs/10 15071 $16.00 $0.00 CPAP mask $50.00 $0.00 Connector T Res iron/ er box 1 $130.00 $130.00 Lg Bitrac Full Face Mask $29.00 $0.00 ET Tube Stylette 71671 $0.00 Wipes Disenfect 211901 $11.52 $0.00 Grand Total $834.89 VOUCHER NO. WARRANT NO. ALLOWED 20 St. Vincent Hospital Attn: Carolyn Terry, Acct. Reporting IN SUM OF$ 10330 N. Meridian Street, Ste. 430 N Indianapolis, IN 46290 $1,879.29 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO#/Dept. INVOICE NO. ACCT#IrITLE AMOUNT Board Members 1120 13406 102-390.11 $1,879.29 1 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 j U N I 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)) 13406 $1,879.29 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