243058 03/11/15 L,q
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CITY OF CARMEL, INDIANA VENDOR: 360209
ONE CIVIC SQUARE ST VINCENT HOSPITAL CHECK AMOUNT: $*""**1,230.94*
CARMEL, INDIANA 46032 ATTN:KATREENA SHIREY ACCT.RPTNG CHECK NUMBER: 243058
9M�3"ori ` 10330 N MERIDIAN ST SUITE 430 CHECK DATE: 03/11/15
INDIANAPOLIS IN 46290
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
102 4239011 13517 1,230.94 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 3/4/2015 13517
BILL TO
Carmel Fire EMS
Attn: Denise Snyder
2 Carmel Civic Square
Carmel, IN 46032
TERMS
Due on receipt
DESCRIPTION AMOUNT
EMS Supplies Purchased February 2015 1,230.94
Drug Transfer
Total $19230.94
Inquiries: Katreena Shirey Payments/Credits $0.00
317.583-3324
katreena.shirey@stvincent.org Balance Due $19230.94
VOUCHER NO. WARRANT NO.
ALLOWED 20
St. Vincent Hospital
IN SUM OF $
Attn: Carolyn Terry, Acct. Reporting
10330 N. Meridian Street, Ste. 430 N
Indianapolis, IN 46290
$1,230.94
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1120 13517 102-390.11 $1,230.94 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
I
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WQ -jj
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))
13517 $1,230.94
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