HomeMy WebLinkAbout239800 12/03/14 ♦y ut G.1gyf .
/ CITY OF CARMEL, INDIANA VENDOR: 360209
�i ONE CIVIC SQUARE ST VINCENT HOSPITAL CHECK AMOUNT: $*****1,456.63*
CARMEL, INDIANA 46032 ATTN:KATRINA SHIREY ACCT.REPORTING CHECK NUMBER: 239800
10330 N MERIDIAN ST SUITE 430 CHECK DATE: 12/03/14
INDIANAPOLIS IN 46290
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
102 4239011 13457 1,456.63 SPECIAL DEPT SUPPLIES
St. Vincent Hosp &Healthcare Center, Inc. Invoice
Attn: Katreena Shirey Acct Rptg
10330 N. Meridian St., Suite 430 North DATE INVOICE#
Indianapolis, IN 46290-1024 11/26/2014 13457
BILL TO
Carmel Fire EMS
Attn: Denise Snyder
2 Carmel Civic Square
Carmel, IN 46032
TERMS
Due on receipt
DESCRIPTION AMOUNT
EMS Supplies Purchased August 2014 1,456.63
Transfer Drugs $1,456.63
Total Due $1,456.63
Total $1,456.63
Inquiries: Katreena Shirey Payments/Credits $0.00
317.583-3324
katreena.shirey@stvincent.org Balance Due $1,456.63
Control Controll Control Contro12 TotalPic TotalPicl
02-8213 Carmel Fire Department Acetaminophen Tab 325 MG TYLENOL Tab 325 MG 3000 EA 4 $0.04
02-8213 Carmel Fire Department ADENOSINE INJ 6 MG ADENOSINE INJ 6 MG 2 ML 5 $13.45
02-8213 Carmel Fire Department Albuterol SULF NEB SOL(0.083%) ALBUTEROL SULFATE 0.083%NEB SOL(0.083%) 3 ML 43 $6.88
02-8213 Carmel Fire Department AMIODARONE HCL INJ 50 MG/mL AMIODARONE HYDROCHLORIDE INJ 50 MG/mL 3 ML 5 $38.35
02-8213 Carmel Fire Department Aspirin Tab Chew 81 MG ASPIRIN Tab Chew 81 MG 750 EA 72 $2.16
02-8213 Carmel Fire Department Atropine Sulfate INJ-SYRNG 1 MG/10 mL ATROPINE SULFATE INJ-SYR 1 MG/10 mL 10 ML 28 $215.32
02-8213 Carmel Fire Department CALcium CHLORide INJ-SYRNG 100 MG/mL CALcium CHLORide INJ-SYRNG 100 MG/mL 10 ML 7 $51.03
02-8213 Carmel Fire Department Dextrose-DOPamine INJ 400 MG 1250 mL DEXTROSE/DOPamine HCL INJ 400 MG/250 mL 250 ML 3 $20.04
02-8213 Carmel Fire Department Dextrose INJ-SYRNG 50% DEXTROSE INJ-SYRNG 50% 50 mL 7 $59.85
02-8213 Carmel Fire Department DiphenhydrAMINE INJ 50 MG/mL DIPHENHYDRAMINE HYDROCHLORIDE INJ 50 MG/mL 1 ML 3 $2.10
02-8213 Carmel Fire Department EpiNEPHrine HCL INJ 0.1 MG/ML EPINEPHRINE HCL INJ 0.1 MG/ML 10 ML 21 $90.30
02-8213 Carmel Fire Department Epinephrine INJ 1 MG/ML EpiNEPHrine INJ 1 MG/ML 30 ML 2 $5.08
02-8213 Carmel Fire Department Glucagon INJ 1 MG GLUCAGEN DIAG.KIT INJ 1 MG 1 EA 5 $536.55
02-8213 Carmel Fire Department Glucose(Dextrose)GEL 40% GLUTOSE 15 GEL 40% 15 GM 5 $29.05
02-8213 Carmel Fire Department Hydrogen Peroxide SOL 3% HYDROGEN PEROXIDE SOL 3% 120 ML 3 $1.65
02-8213 Carmel Fire Department Ibuprofen Tab 600 MG IBUPROFEN Tab 600 MG 100 EA 1 $0.04
02-8213 Carmel Fire Department Ibuprofen Tab 800 MG IBU Tab 800 MG 100 EA 2 $0.10
02-8213 Carmel Fire Department Ipratropium SOL 0.02%. IPRATROPIUM BROMIDE SOL 0.02% 2.5 ML 4 $0.64
02-8213 Carmel Fire Department Ketorolac INJ 60 MG/2 mL KETOROLAC TROMETHAMINE INJ 60 MG/2 mL 2 ML 1 $0.68
02-8213 Carmel Fire Department Lidocaine HCL INJ-SYRNG 100 MG LIDOCAINE HCL[NJ-SYRNG 100 MG 5 ML 9 $38.70
02-8213 Carmel Fire Department Lidocaine HCL JELLY 2%30 GM LIDOCAINE JELLY 2%JELLY 2% 30 GM 30 3 $16.89
02-8213 Carmel Fire Department Magnesium SULF INJ 1000 MG/2 mL MAGNESIUM SULFATE INJ 1000 MG/2 mL 2 ML 4 $2.16
02-8213 Carmel Fire Department Naloxone INJ 1 MG/ML NALOXONE HYDROCHLORIDE INJ 1 MG/ML 2 ML 17 $222.02
- 213 Carmel Fire Department Nitroglycerin
Tab 0.4 MG NITROSTAT TAB 0.4 MG 100 ea 1 $10.28
028
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02-8213 Carmel Fire Department Ondansetron INJ 2 mg/mL ONDANSETRON INJ 2 mg/mL 2 ML 23 $7.59
02-8213 Carmel Fire Department Ondansetron Tab ODT 4 MG ONDANSETRON Tab ODT 4 MG 30 EA 16 $2.56
02-8213 Carmel Fire Department Racemic Epinephrine SOL 2.25% UD S-2 INHALANT SOL 2.25% UD 0.5 ML 5 $5.75
02-8213 Carmel Fire Department Sodium Bicarbonate INJ 4.2% SODIUM BICARBONATE INJ 4.2% 10 ML 2 $14.46
02-8213 Carmel Fire Department Sodium Bicarbonate INJ 7.5% SODIUM BICARBONATE INJ 7.5% 50 ML 4 $41.76
02-8213 Carmel Fire Department Sodium Chloride INJ 0.9% 1000 mL SODium CHLORide 0.9% INJ 0.9% 1000 mL 1000 ML 21 $16.59
02-8213 Carmel Fire Department Sodium Chloride INJ 0.9%500 mL SODium CHLORide 0.9% INJ 0.9%500 mL 500 ML 6 $4.56
$1,456.63
VOUCHER NO. WARRANT NO.
ALLOWED 20
St. Vincent Hospital
Attn: Carolyn Terry, Acct. Reporting IN SUM OF$
I
10330 N. Meridian Street, Ste. 430 N
Indianapolis, IN 46290
$1,456.63
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1120 13457 102-390.11 $1,456.63 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
DEC 1 2011
E_
ee
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))
13457 $1,456.63
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