The URL can be used to link to this page

Home My WebLink About240444 12/16/14 y ur C�Ab �FCITY OF CARMEL, INDIANA VENDOR: 360209 °• ONE CIVIC SQUARE ST VINCENT HOSPITAL CHECK AMOUNT: $*****6,184.79* ATTN:CAROLYN TERRY ACCT.REPORTING CHECK NUMBER: 240444 CARMEL, INDIANA 46032 10330 N MERIDIAN ST SUITE 430 AroN�° CHECK DATE: 12/16/14 INDIANAPOLIS IN 46290 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 102 4239011 13464 820.05 SPECIAL DEPT SUPPLIES 102 4239011 13465 745.14 SPECIAL DEPT SUPPLIES 102 4239011 13466 916.71 SPECIAL DEPT SUPPLIES 102 4239011 13473 1,121.04 SPECIAL DEPT SUPPLIES 102 4239011 13474 1,311.31 SPECIAL DEPT SUPPLIES 102 4239011 13475 1,270.54 SPECIAL DEPT SUPPLIES i 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 12/8/2014 13466 BILL TO Carmel Fire EMS Attn: Denise Snyder 2 Carmel Civic Square Carmel, IN 46032 TERMS Due on receipt DESCRIPTION AMOUNT EMS Supplies Purchased November 2014 916.71 Transfer Drugs $916.71 Total Due - $916.71 Total $916.71 Inquiries: Katreena Shirey Payments/Credits $0.00 317.583-3324 katreena.shirey@stvincent.org Balance Due $916.71 Control Controll Control Control2 TotalPic TotalPicl 02-8213 Carmel Fire Department Acetaminophen Tab 325 MG TYLENOL Tab 325 MG 3000 EA 5 $0.05 02-8213 Carmel Fire Department ADENOSINE INJ 6 MG ADENOSINE INJ 6 MG 2 ML 3 $8.07 02-8213 Carmel Fire Department Albuterol SULF NEB SOL(0.083%) ALBUTEROL SULFATE 0.083%NEB SOL(0.083%) 3 ML 21 $3.36 02-8213 Carmel Fire Department AMIODARONE HCL INJ 50 MG/mL AMIODARONE HYDROCHLORIDE INJ 50 MG)mL 3 ML 23 $17.94 02-8213 Carmel Fire Department Aspirin Tab Chew 81 MG ASPIRIN Tab Chew 81 MG 750 EA 144 $4.32 02-8213 Carmel Fire Department Atropine Sulfate INJ-SYRNG 1 MG/10 mL ATROPINE SULFATE INJ-SYR 1 MG/10 mL 10 ML 6 $46.14 02-8213 Carmel Fire Department Dextrose INJ-SYRNG 50% DEXTROSE INJ-SYRNG 50% 50 mL 2 $17.10 02-8213 Carmel Fire Department EpiNEPHdne HCL INJ 0.1 MG/ML EPINEPHRINE HCL INJ 0.1 MG/ML 10 ML 10 $43.00 02-8213 Carmel Fire Department Glucagon INJ 1 MG GLUCAGEN DIAG.KIT INJ 1 MG 1 EA 1 $123.91 02-8213 Carmel Fire Department Glucose(Dextrose)GEL 40% GLUTOSE 15 GEL 40% 15 GM 2 $11.62 02-8213 Carmel Fire Department Ipratropium SOL 0.02% IPRATROPIUM BROMIDE SOL 0.02% 2.5 ML 3 $0.48 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 2 $26.12 02-8213 Carmel Fire Department Nitroglycerin Tab 0.4 MG NITROSTAT TAB 0.4 MG 100 ea 2 $21.16 02-8213 Carmel Fire Department Ondansetron INJ 2 mg/mL ONDANSETRON INJ 2 mg/mL 2 ML 12 $3.96 02-8213 Carmel Fire Department Ondansetron Tab ODT 4 MG ONDANSETRON Tab ODT 4 MG 30 EA 4 $0.64 02-8213 Carmel Fire Department Racemic Epinephrine SOL 2.25% UD S-2 INHALANT SOL 2.25%UD 0.5 ML 2 $2.30 02-8213 Carmel Fire Department Sodium Bicarbonate INJ 7.5% SODIUM BICARBONATE INJ 7.5% 50 ML 1 $10.44 02-8213 Carmel Fire Department Sodium Chloride INJ 0.9% 1000 mL SODium CHLORide 0.9% INJ 0.9% 1000 mL 1000 ML 30 $23.70 02-8213 Carmel Fire Department Sodium Chloride INJ 0.9%500 mL SODium CHLORide 0.9% INJ 0.9%500 mL 500 ML 9 $6.84 02-8213 Carmel Fire Department Tuberculin INJ(PPD)5 Units/0.1mL TUBERSOL UD INJ(PPD)5 Units/0.1ml- 0.1 ML 380 $543.40 $916.71 �V i 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 12/8/2014 13465 BILL TO. Cannel Fire EMS Attn: Denise Snyder 2 Cannel Civic Square Cannel, IN 46032 TERMS Due on receipt DESCRIPTION AMOUNT EMS Supplies October 2014 745.14 Transfer Drugs $745.14 Total Due $745.14 Total $745.14 Inquiries: Katreena Shirey Payments/Credits $0.00 317.583-3324 katreena.shirey@stvincent.org Balance Due $745.14 Control Controll Control Contro12 TotalPic TotalPicl 02-8213 Carmel Fire Department Acetaminophen Tab 325 MG TYLENOL Tab 325 MG 3000 EA 6 0.06 02-8213 Carmel Fire Department ADENOSINE INJ 6 MG ADENOSINE INJ 6 MG 2 ML 11 29.59 02-8213 Carmel Fire Department Albuterol SULF NEB SOL(0.083%) ALBUTEROL SULFATE 0.083% NEB SOL(0.083%) 3 ML 13 2.08 02-8213 Carmel Fire Department AMIODARONE HCL INJ 50 MG/mL AMIODARONE HYDROCHLORIDE INJ 50 MG/mL 3 ML 31 24.18 02-8213 Carmel Fire Department Aspirin Tab Chew 81 MG ASPIRIN Tab Chew 81 MG 750 EA 36 1.08 02-8213 Carmel Fire Department Atropine Sulfate INJ-SYRNG 1 MGI 10 mL ATROPINE SULFATE INJ-SYR 1 MG/10 mL 10 ML 1 7.69 02-8213 Carmel Fire Department Dextrose INJ-SYRNG 50% DEXTROSE INJ-SYRNG 50% 50 mL 3 25.65 02-8213 Carmel Fire Department DiphenhydrAMINE INJ 50 MG/mL DIPHENHYDRAMINE HYDROCHLORIDE INJ 50 MG/rT L 1 ML 7 4.9 02-8213 Carmel Fire Department EpiNEPHrine HCL INJ 0.1 MG/ML EPINEPHRINE HCL INJ 0.1 MG/ML 10 ML 20 86 02-8213 Carmel Fire Department Epinephrine INJ 1 MG/ML EpiNEPHrine INJ 1 MG/ML 30 ML 1 2.54 02-8213 Carmel Fire Department Glucagon INJ 1 MG GLUCAGEN DIAG. KIT INJ 1 MG 1 EA 3 371.73 02-8213 Carmel Fire Department Ipratropium SOL 0.02% IPRATROPIUM BROMIDE SOL 0.02% 2.5 ML 1 0.16 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 INJ-SYRNG 100 MG 5 ML 3 12.9 02-8213 Carmel Fire Department Lidocaine HCL JELLY 2%30 GM LIDOCAINE JELLY 2%JELLY 2%30 GM 30 2 11.26 02-8213 Carmel Fire Department Magnesium SULF INJ 1000 MG/2 mL MAGNESIUM SULFATE INJ 1000 MG/2 mL 2 ML 2 1.08 02-8213 Carmel Fire Department Naloxone INJ 1 MG/ML NALOXONE HYDROCHLORIDE INJ 1 MG/ML 2 ML 7 91.42 02-8213 Carmel Fire Department Nitroglycerin Tab 0.4 MG NITROSTAT TAB 0.4 MG 100 ea 1 10.28 02-8213 Carmel Fire Department Ondansetron INJ 2 mg/mL ONDANSETRON INJ 2 mg/mL 2 ML 16 5.28 02-8213 Carmel Fire Department Ondansetron Tab ODT 4 MG ONDANSETRON Tab ODT 4 MG 30 EA 3 0.48 02-8213 Carmel Fire Department Sodium Bicarbonate INJ 4.2% SODIUM BICARBONATE INJ 4.2% 10 ML 1 7.23 02-8213 Carmel Fire Department Sodium Bicarbonate INJ 7.5% SODIUM BICARBONATE INJ 7.5% 50 ML 1 10.44 02-8213 Carmel Fire Department Sodium Chloride INJ 0.9% 1000 mL SODium CHLORide 0.9% INJ 0.9% 1000 mL 1000 ML 27 21.33 02-8213 Carmel Fire Department Sodium Chloride INJ 0.9%50 mL SODium CHLORide 0.9% INJ 0.9%50 mL 50 ML 6 12.54 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. 745.14 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 12/8/2014 13464 BILL TO Carmel Fire EMS Attn: Denise Snyder 2 Carmel Civic Square Carmel, IN 46032 TERMS Due on receipt DESCRIPTION AMOUNT EMS Supplies Purchased September 2014 820.05 Transfer Drugs - $820.05 Total Due- $820.05 Total $820.05 Inquiries: Katreena Shirey Payments/Credits $0.00 317.583-3324 katreena.shirey@stvincent.org Balance Due $820.05 Control Controll Control Contro12 TotalPic TotalPicl 02-8213 Carmel Fire Department Albuterol SULF NEB SOL(0.083%) ALBUTEROL SULFATE 0.083% NEB SOL(0.083% 3 ML 16 $2.56 02-8213 Carmel Fire Department Aspirin Tab Chew 81 MG ASPIRIN Tab Chew 81 MG 750 EA 108 $3.24 02-8213 Carmel Fire Department Atropine Sulfate INJ-SYRNG 1 MG/10 mL ATROPINE SULFATE INJ-SYR 1 MG/10 mL 10 ML 18 $138.42 02-8213 Carmel Fire Department CALcium CHLORide INJ-SYRNG 100 MG/mL CALcium CHLORide INJ-SYRNG 100 MG/mL 10 ML 5 $36.45 02-8213 Carmel Fire Department Dextrose-DOPamine INJ 400 MG/250 mL DEXTROSE/DOPamine HCL INJ 400 MG/250 mL 250 ML 1 $11.38 02-8213 Carmel Fire Department Dextrose INJ-SYRNG 50% DEXTROSE INJ-SYRNG 50% 50 mL 11 $94.05 02-8213 Carmel Fire Department DiphenhydrAMINE INJ 50 MG/mL DIPHENHYDRAMINE HYDROCHLORIDE INJ 50 MG/mL 1 ML 6 $4.20 02-8213 Carmel Fire Department EpiNEPHrine HCL INJ 0.1 MG/ML EPINEPHRINE HCL INJ 0.1 MG/ML 10 ML 33 $141.90 02-8213 Carmel Fire Department FentaNYL SYR INJ 100 MCG/2 mL FENTANYL CITRATE INJ 100 MCG/2 mL 2 ML 28 $36.12 02-8213 Carmel Fire Department Glucagon INJ 1 MG GLUCAGEN DIAG.KIT INJ 1 MG 1 EA 1 $123.91 02-8213 Carmel Fire Department Glucose(Dextrose)GEL 40% GLUTOSE 15 GEL 40% 15 GM 4 $23.24 02-8213 Carmel Fire Department Ipratropium SOL 0.02% IPRATROPIUM BROMIDE SOL 0.02% 2.5 ML 2 $0.32 02-8213 Carmel Fire Department Lidocaine HCL INJ-SYRNG 100 MG LIDOCAINE HCL INJ-SYRNG 100 MG 5 ML 6 $25.80 02-8213 Carmel Fire Department Lidocaine HCL JELLY 2%30 GM LIDOCAINE JELLY 2%JELLY 2%30 GM 30 4 $22.52 02-8213 Carmel Fire Department MIDAZOLAM INJ 10 MG/2 mL MIDAZOLAM HCL INJ 10 MG/2 mL 2 ML 3 $2.52 02-8213 Carmel Fire Department Naloxone INJ 1 MG/ML NALOXONE HYDROCHLORIDE INJ 1 MG/ML 2 ML 4 $52.24 02-8213 Carmel Fire Department Nitroglycerin Tab 0.4 MG NITROSTAT TAB 0.4 MG 100 ea 3 $30.84 02-8213 Carmel Fire Department Ondansetron INJ 2 mg/mL ONDANSETRON INJ 2 mg/mL 2 ML 22 $7.26 02-8213 Carmel Fire Department Ondansetron Tab ODT 4 MG ONDANSETRON Tab ODT 4 MG 30 EA 14 $2.24 02-8213 Carmel Fire Department Sodium Bicarbonate INJ 4.2% SODIUM BICARBONATE INJ 4.2% 10 ML 1 $7.23 02-8213 Carmel Fire Department Sodium Bicarbonate INJ 7.5% SODIUM BICARBONATE INJ 7.5% 50 ML 3 $31.32 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%50 mL SODium CHLORide 0.9% INJ 0.9%50 mL 50 ML 2 $4.18 02-8213 Carmel Fire Department Sodium Chloride INJ 0.9%500 mL SODium CHLORide 0.9% INJ 0.9%500 mL 500 ML 2 $1.52 $820.05 St. Vincent Hosp &Healthcare Center, Inc. Invoice Attn: Katreena Shirey Acct Rptg 10330 N. Meridian St., Suite 430 North DATE INVOICE# lis IN 46290-1024 Indianapolis, 12/8/2014 13473 BILL TO Carmel Fire EMS Attn: Denise Snyder 2 Carmel Civic Square Carmel, IN 46032 TERMS Due on receipt DESCRIPTION AMOUNT EMS Supplies Purchased September 2014 1,121.04 Transfer Medical Supplies - $1,121.04 Total $1,121.04 Inquiries: Katreena Shirey Payments/Credits $0.00 317.583-3324 katreena.shirey@stvincent.org Balance Due $19121.04 Depatmental Transfer of Supplies date submissed Requesting Department: Carmel Fire Dept Supplying Department ER Cost Center 8213 Cost Center 27230 QUANTITY UNIT COST TOTAL COST Alcohol preps $2.67 $0.00 Angiocath 18g 38 $1.50 $57.00 Angiocath 20g 78 $1.50 $117.00 Angiocath 20g 1.88 per box $95.00 $0.00 Angiocath 22g 10 $1.50 . $15.00 Angiocath 24g 30 $1.55 $46.50 Basin kidney shaped $0.08 $0.00 Basin round $0.31 $0.00 Capnography NC Adult 1 Coban 1' Roll (ea) $1.75 $0.00 Cold paks $0.57 $0.00 Dressing-Curtis Bandage 1 box 2 $9.92 $19.84 EKG Electrodes $3.12 $0.00 Emesis Bags (per pack) 1 $11.52 $11.52 EZ-10 Adult Needles ($495.00/box of 5) 1 $99.00 $99.00 Filter Needle Wellsoft/5 Micron Filer Foam -Quikcare $2.67 $0.00 Guaze, 2 x 2 Cotton bail $1.88 $0.00 Guaze, 2 X 2 Sterile $0.02 $0.00 Gauze 4 X 3 sponge(per box) $1.24 $0.00 Gauze 4 x 4 tub 12 $0.32 $3.84 Gauze Kerlex $0.67 $0.00 Gloves-Med 2 $5.41 $10.82 Gloves-Large 1 $5.41 $5.41 Sep-14 Gloves-Marge 1 $5.95 $5.95 Supplies IV Adapter, Luerlock $0.15 $0.00 IV Dial a flow $3.15 $0.00 IV Extension 19" 2 $1.91 $3.82 IV Lock with Ext 119 $1.87 $222.53 IV Start Kits (100/bx) 271 $1.00 $271.00 IV Start Kits Sobraview(100/bx) 5 $2.66 $13.30 IV Tubing 15gtt 45 $1.17 $52.65 KY pkt $0.10 $0.00 Kerlix 4.5"x6ply 16 $0.73 $11.68 Lancet-Saf-T Pro(200 per box) 25 $0.17 $4.25 Microdot Xtra Test Strips $24.95 $0.00 Microdot Xtra Control Solutions $12.00 $0.00 Normal Saline 1000 cc bags/ca Razor, disposeable $0.12 $0.00 Scapel#11 $1.30 $0.00 Sharps Container $4.59 $0.00 Sterile H2O bottle $0.71 $0.00 Suction Canister&top $3.26 $0.00 Suture Kit 1 $1.09 $0.00 Syringe w/Needle 1 ml $0.07 $0.00 Syringe w/Needle 3 ml 35 0.051 $1.75 Syringe w/Needle 5ml 10 $0.101 $1.00 Syringe w/Needle 10 ml 10 $0.12 $1.20 Syringe w Saline 3ml 40 $0.28 $11.20 Syringe w/Saline10ml 230 $0.32 $73.60 30 ml saline vials (per box) 3 $9.63 $28.89 Tape 2"(6 rolls/box) 1.00 $0.00 Tape 1" $0.50 $0.00 Tape 2"cloth adh $1.29 $0.00 Tape Transpore 1/2" $1.28 $0.00 Tegaderm $0.24 $0.00 Telfa Dressing $0.12 $0.00 Thermometer Probe Covers/per box 1 $2.891 $2.89 Tourniguets (50/pkg) $0.11 $0.00 Ultra Trak Ultimate Test Control $83.30 Ultra Trak Ultimate Test Strips/10 BX $330.00 $0.00 Warm paks $1.46 $0.00 Wound Cleanser $5.04 $0.00 Suction Canister&top $3.26 $0.00 Yankauers 2 $0.34 $0.68 Ambu Bag w/mask-Adult 2 $8.60 $17.20 Ambu Bag w/mask-Peds cs/10 $126.00 $0.00 Ambu Bag w/mask- Infant cs/10 $16.00 $0.00 CPAP mask-1 case/10 $919.99 $0.00 Lg Bitrac Full Face Mask $29.00 $0.00 ET Tube Stylette $0.00 Wipes Disenfect 1 $11.52 $11.52 Grand Total $1,121.04 Approved by date St. Vincent Hosp &Healthcare Center, Inc. invoice Attn: Katreena Shirey Acct Rptg DATE INVOICE# 10330 N. Meridian St., Suite 430 North Indianapolis, IN 46290-1024 12/8/2014 13475 BILL TO Carmel Fire EMS Attn: Denise Snyder 2 Carmel Civic Square Carmel, IN 46032 TERMS Due on receipt DESCRIPTION AMOUNT . EMS Supplies Purchased-November 2014 1,270.54 Transfer Medical Supplies -$1,270.54 Total $11270.54 Inquiries: Katreena Shirey Payments/Credits $0.00 317.583-3324 katreena.shirey@stvincent.org Balance Due $11,270.54 III . Depatmental Transfer of Supplies date submissed Cost Center 8213 Cost Center 27230 QUANTITY UNIT COST TOTAL COST Alcohol preps 1 $1.96 $1.96 Angiocath 18g 5 $1.50 $7.50 Angiocath 20g 64 $1.50 $96.00 Angiocath 20g 1.88 per box 2 $95.00 $190.00 Angiocath 22g $1.50 $0.00 Angiocath 24g $1.55 $0.00 Basin kidney shaped $0.08 $0.00 Basin round $0.31 $0.00 Coban 1' Roll (ea) $1.75 $0.00 Cold paks $0.57 $0.00 EKG Electrodes 2 $3.12 . $6.24 Emesis Bags(per pack) 4 $11.52 $46.08 EZ-10 Adult Needles ($495.00/box of 5) $99.00 $0.00 Nov 2014 Supplies Foam-Quikcare $2.67 Guaze, 2 x 2 Cotton bail $1.881 $0.00 Guaze, 2 X 2 Sterile $0.02 $0.00 Gauze 4 X 3 sponge(per box) $1.24 $0.00 Gauze 4 x 4 tub 4 $0.32 $1.28 Gauze Kerlex 1 $0.67 $0.67 Glidescope Disposable-Blades-SZ 3 1 $18.05 $18.05 Glidescope Disposable Blades-SZ 4 1 $18.05 $18.05 Gloves-Med 1 $10.35 $10.35 Gloves-Large 10 $10.35 $103.50 Gloves-Marge $10.35 $0.00 IV Adapter, Luerlock 22 $0.15 $3.30 IV Dial a flow $3.15 $0.00 IV Extension 19" $1.91 $0.00 IV Lock with Ext 57 $1.87 $106.59 IV Start Kits ea 99 $2.88 $285.12 IV Start Kits Sobraview(100/bx) $2.66 $0.00 IV Tubing 15gtt 5 $1.17 $5.85 Kerlix 4.5"x6ply $0.73 $0.00 Microdot Xtra Test Strips 10 $24.95 $249.50 Microdot Xtra Control Solutions $12.00 $0.00 Normal Saline 1000 cc bags/ca $9.48 $0.00 Razor, disposeable 10 $0.12 $1.20 Scapel#11 $1.30 $0.00 Sharps Container $4.59 $0.00 Sterile H2O bottle $0.71 $0.00 Suction Canister&top 1 3.261 3.26 Suture Kit 1 $1.09 $0.00 Syringe w/Needle 1 ml $0.07 $0.00 Syringe w/Needle 3 ml 25 $0.05 $1.25 Syringe w/Needle 5ml $0.10 $0.00 Syringe w/Needle 10 ml 11 $0.12 $1.32 Syringe w Saline 3ml $0.281 $0.00 Syringe w/Saline10ml 7 0.321 $2.24 30 ml saline vials (per box) 6 9.631 $57.78 Tape 2"(6 rolls/box) 1 $1.001 $1.00 Tape 1" 8 $0.501 4.00 Tape 2"cloth adh 1 $1.291 1.29 Tape Transpore 1/2" $1.28 $0.00 Warm paks 4 $1.46 $5.84 Wound Cleanser $5.04 $0.00 Suction Canister&top $3.26 $0.00 Yankauers $0.34 $0.00 Ambu Bag w/mask-Adult 2 $8.601 $17.20 Ambu Bag w/mask-Peds cs/10 1 $126.00 1 $0.00 Ambu Bag w/mask- Peds 1 $12.60 $12.60 Ambu Bag w/mask- Infant cs/10 $16.00 $0.00 CPAP mask- 1 case/10 $919.99 $0.00 Lg Bitrac Full Face Mask $29.00 $0.00 ET Tube Stylette $0.00 Wipes Disenfect 1 $11.52'1 $11.52 Grand Total $1,270.54 Approved by date 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 12/8/2014 13474 BILL TO Carmel Fire EMS Attn: Denise Snyder 2 Carmel Civic Square Carmel, IN 46032 TERMS Due on receipt DESCRIPTION AMOUNT EMS Supplies Purchased - October 2014 1,311.31 Medical Supplies - $1,311.31 Total $19311.31 Inquiries: Katreena Shirey Payments/Credits $0.00 317.583-3324 katreena.shirey@stvincent.org Balance Due $19311.31 Depatmental Transfer of Supplies date submissed Requesting Department: Carmel Fire Dept Supplying Department ER Cost Center 8213 Cost Center 27230 QUANTITY UNIT COST TOTAL COST Alcohol preps 10 $2.67 $26.70 Ace Wrap 4 8 $0.25 $2.00 Angiocath 18g 33 $1.50 $49.50 Angiocath 20g 38 $1.50 $57.00 Angiocath 20g 1.88 per box $95.00 $0.00 Angiocath 22g 5 $1.50 $7.50 Angiocath 24g 5 $1.55 $7.75 Basin kidney shaped $0.08 $0.00 Basin round $0.31 $0.00 Coban 1' Roll (ea) $1.75 $0.00 Cold paks $0.57 $0.00 EKG Electrodes $3.12 $0.00 Emesis Bags per pack) 1 $11.52 $11.52 Oct 2014 Supplies EZ-10 Adult Needles ($495.00/box of 5) $99.00 $0.00 Filter Needle Wellsoft/5 Micron Filer Foam-Quikcare $2.67 $0.00 Guaze, 2 x 2 Cotton bail $1.88 $0.00 Guaze, 2 X 2 Sterile 0.021 $0.00 Gauze 4 X 3 sponge(per box) 7 $1.24 $8.68 Gauze 4 x 4 tub 12 $0.32 $3.84 Gauze Kerlex 21 $0.67 $14.07 Gloves -Med $5.41 $0.00 Gloves-Large 5 $5.41 $27.05 Gloves-Xlarge 3 $5.95 $17.85 IV Adapter, Luerlock 10 $0.15 $1.50 IV Dial a flow $3.15 $0.00 IV Extension 19" $1.91 $0.00 IV Lock with Ext 93 $1.87 $173.91 IV Start Kits(100/bx) 93 $1.00 $93.00 IV Start Kits Sobraview(100/bx) 8 $2.66 $21.28 IV Tubing 15gtt 23 $1.17 $26.91 KY pkt $0.10 $0.00 Kerlix 4.5"x6pIY $0.73 $0.00 BD Lancet box 2 $60.50 $121.00 Mask Resp Particulate(Case) 4 $64.80 $259.20 Microdot Xtra Test Strips 10 $29.95 $299.50 Microdot Xtra Control Solutions $12.00 $0.00 Normal Saline 1000 cc bag ca $9.48 Razor, disposeable $0.12 $0.00 Scapel#11 $1.30 $0.00 Sharps Container $4.59 $0.00 Sterile H2O bottle $0.71 $0.00 Suction Canister&top $3.26 $0.00 Suture Kit 1 $1.091 $0.00 Syringe w/Needle 1 ml $0.07 $0.00 Syringe w/Needle 3 ml 10 $0.05 $0.50 Syringe w/Needle 5ml $0.10 $0.00 Syringe w/Needle 10 ml $0.12 $0.00 Syringe w Saline 3ml $0.28 $0.00 Syringe w/Saline10ml 65 $0.32 $20.80 30 ml saline vials per box) 5 $9.63 $48.15 Tape 2"(6 rolls/box) 3 $1.00 $3.00 Tape 1" 1 $0.50 $0.50 Tape 2"cloth adh $1.29 $0.00 Tape Transpore 1/2" $1.28 $0.00 Tegaderm $0.241 $0.00 Telfa Dressing $0.121 $0.00 Tourniguets 50/pkg) $0.111 $0.00 Warm paks $1.46 $0.00 Wound Cleanser $5.04 $0.00 Suction Canister&top $3.26 $0.00 Yankauers $0.34 $0.00 Ambu Bag w/mask-Adult 1 $8.60 $8.60 Ambu Bag w/mask- Peds cs/10 $126.00 $0.00 Ambu Bag w/mask- Infant cs/10 $16.00 $0.00 CPAP mask-1 case/10 $919.99 $0.00 Lg Bitrac Full Face Mask $29.00 $0.00 ET Tube Stylette $0.00 Wipes Disenfect $11.52 $0.00 Grand Total $1,311.31 Approved by date 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 $6,184.79 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1120 13465 102-390.11 $745.14 1 hereby certify that the attached invoice(s), or 1120 13464 102-390.11 $820.05 bill(s) is(are)true and correct and that the 1120 13473 102-390.11 $1,121.04 materials or services itemized thereon for 1120 13475 102-390.11 $1,270.54 which charge is made were ordered and 1120 13474 102-390.11 $1,311.31 received except 1120 13466 102-390.11 $916.71C, X196. 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,whereerformed, 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)) 13465 $745.14 13464 $820.05 13473 $1,121.04 13475 $1,270.54 13474 $1,311.31 13466 $916.71 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