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245287 05/13/15 CITY OF CARMEL, INDIANA VENDOR: 360209 ONE CIVIC SQUARE ST VINCENT HOSPITAL CHECK AMOUNT: $*****2,145.55* ,. CARMEL, INDIANA 46032 ATTN:CAROLYN TERRY ACCT.RPTNG CHECK NUMBER: 245287 10330 N MERIDIAN ST SUITE 430 CHECK DATE: 05/13/15 F RioN�° INDIANAPOLIS IN 46290 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 102 4239011 13547 2,145.55 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 4/30/2015 13547 BILL TO Carmel Fire EMS Attn: Denise Snyder 2 Carmel Civic Square Carmel, IN 46032 TERMS Due on receipt DESCRIPTION AMOUNT EMS Supplies Purchased-April 2015 2,145.55 Drugs Purchased Total $29145.55 Inquiries: Katreena Shirey Payments/Credits $0.00 317.583-3324 katreena.shirey@stvincent.org Balance Due $29145.55 VOUCHER NO. WARRANT NO. St. Vincent Hospital �, ALLOWED 20 Attn: Carolyn Terry, Acct. Reporting IN SUM OF$ 10330 N. Meridian Street, Ste. 430 N Indianapolis, IN 46290 $2,145.55 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO#/Dept. INVOICE NO. ACCT#!TITLE AMOUNT Board Members 1120 13547 102-390.11 $2,145.55 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 MAY `� X015 � /-,A 10, -7 - Fire Chief Title • I 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)) 13547 $2,145.55 I �I 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