252794 12/15/15 *F CITY OF CARMEL, INDIANA VENDOR: 360209
ONE CIVIC SQUARE ST VINCENT HOSPITAL CHECK AMOUNT: $*****4,415.1 1*
f. =a CARMEL, INDIANA 46032 ATTN:KATREENA SHIREY CHECK NUMBER: 252794
10330 N MERIDIAN ST SUITE 430 CHECK DATE: 12/15/15
INDIANAPOLIS IN 46290
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
102 4239011 13671 3,476.51 SPECIAL DEPT SUPPLIES
102 4239011 13692 938.60 SPECIAL DEPT SUPPLIES
St. Vincent Hosp & Healthcare Center, Inc. Invoice
Attn: Carolyn Terry, Acct Rptg
10330 N. Meridian St., Suite 430 North DATE INVOICE#
Indianapolis, IN 46290-1024 11/30/2015 13671
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 and November 2015 3,476.51
Medical Supplies (Oct. &Nov): 2,365.57
Transfer Drugs (Nov): 1,110.94
Total November due: $3,476.51
46029-160085-65050. Please note invoice number Tota' $3,476.51
that you are paying on check/stub. Thank you!
Inquiries: Carolyn Terry Payments/Credits $0.00
CMTerry@stvincent.org Balance Due $3,476.51
5
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))
13671 $3,476.51
1 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
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
$3,476.51
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1120 13671 102-390.11 $3,476.51 I 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 4 2015
r. - A'
4.
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
St. Vincent Hosp & Healthcare Center, Inc. Invoice
Attn: Carolyn Terry, Acct Rptg
10330 N. Meridian St., Suite 430 North DATE INVOICE#
Indianapolis, IN 46290-1024 12/10/2015 13692
BILL TO
Carmel Fire EMS
Attn: Denise Snyder
2 Carmel Civic Square
Carmel, IN 46032
TERMS
Due on receipt
DESCRIPTION AMOUNT
2016 Protocol Books 938.60
100 small @ $8.95 each= $895.00
2 large @ $21.80 each= $43.60
46029-160085-65050. Please note invoice number Total $938.60
that you are paying on check/stub. Thank you!
Inquiries: Carolyn Terry Payments/Credits $0.00
CMTerry@stvincent.org Balance Due $938.60
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))
13692 $938.60
1 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
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
$938.60
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT
Board Members
1120 13692 102-390.11 $938.60 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 4 2015
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund