HomeMy WebLinkAbout258037 04/26/16 CITY OF CARMEL, INDIANA VENDOR: 360209
ONE CIVIC SQUARE ST VINCENT HOSPITAL CHECK AMOUNT: S""'"1,171.69•
CARMEL, INDIANA 46032 ATTN:KATREENA SHIREY CHECK NUMBER: 258037
10330 N MERIDIAN ST SUITE 430 CHECK DATE: 04/26/16
INDIANAPOLIS IN 46290
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4239011 13747 1,171.69 SPECIAL DEPT SUPPLIES
'rescribed by State Board of Accounts City Form No.201 (Rev.1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
kn invoice or bill to be properly itemized must show: kind of service,where performed,dates service rendered, by
vhom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
Terms
Date Due
nvoice Date Invoice# Description Amount
Dept. Fund# (or note attached invoice(s) or bill(s))
04/13/16 I 13747 $1,171.69
$1,171.69
1120 102
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:IG4TREENA SHIREY
IN SUM OF $
10330 N MERIDIAN ST SUITE 430
INDIANAPOLIS, IN 46290
$1,171.69
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire
PO#/Dept. INVOICE NO. I ACCT#/Fund AMOUNT Board Members
13747 I 42-390.11 I $1,171.69 1 hereby certify that the attached invoice(s), or
1120 102
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
Thursday, April 14, 2016
vamDr '2S-
David Haboush
Fire Chief
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 3/31/2016 13747
BILL TO
Carmel Fire EMS
Attn: Denise Snyder
2 Carmel Civic Square
Carmel, IN 46032
TERMS
Due on receipt
DESCRIPTION AMOUNT
EMS Supplies purchased March 2016 1,171.69
Transfer Drugs $1,171.69
46029-160085-65050. Please note invoice number Total $1,171.69
that you are paying on check/stub. Thank you!
Inquiries: Carolyn Terry Payments/Credits $0.00
CMTerry@stvincent.org Balance Due $19171.69
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 20 $45.00
02-8213 Carmel Fire Department Albuterol SULF NEB SOL(0.083%) ALBUTEROL SULFATE 0.083%NEB SOL(0.083%) 3 ML 18 $2.88
02-8213 Carmel Fire Department AMIODARONE HCL INJ 50 MG/mL AMIODARONE HYDROCHLORIDE INJ 50 MG/mL 3 ML 2 $1.56
02-8213 Carmel Fire Department Aspirin Tab Chew 81 MG ASPIRIN Tab Chew 81 MG 750 EA 216 $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 4 $30.76
02-8213 Carmel Fire Department CALcium CHLORide INJ-SYRNG 100 MG/mL CALcium CHLORide INJ-SYRNG 100 MG/mL 10 ML 2 $14.58
02-8213 Carmel Fire Department Dextrose-DOPamine INJ 400 MG/250 mL DEXTROSE/DOPamine HCL INJ 400 MG 1250 mL 250 ML 3 $18.69
02-8213 Carmel Fire Department Dextrose INJ-SYRNG 50% DEXTROSE INJ-SYRNG 50% 50 mL 6 $51.30
02-8213 Carmel Fire Department DiphenhydrAMINE INJ 50 MG/mL DIPHENHYDRAMINE HYDROCHLORIDE INJ 50 MG/mL 1 ML 1 $0.56
02-8213 Carmel Fire Department EpiNEPHrine HCL INJ 0.1 MG/ML EPINEPHRINE HCL INJ 0.1 MG/ML 10 ML 27 $115.87
02-8213 Cannel Fire Department Glucagon INJ 1 MG GLUCAGEN DIAG.KIT INJ 1 MG 1 EA 2 $199.28
02-8213 Carmel Fire Department Glucagon INJ 1 MG GLUCAGON EMERGENCY KIT INJ 1 MG 1 EA 3 $336.36
02-8213 Carmel Fire Department Glucose(Dextrose)GEL 40% GLUTOSE 15 GEL 40% 15 GM 4 $23.24
02-8213 Carmel Fire Department Hydrogen Peroxide SOL HYDROGEN PEROXIDE SOL 480 ML 2 $1.46
02-8213 Carmel Fire Department Ipratropium SOL 0.02% IPRATROPIUM BROMIDE SOL 0.02% 2.5 ML 9 $1.44
02-8213 Carmel Fire Department Ketorolac INJ 60 MG/2 mL KETOROLAC TROMETHAMINE INJ 60 MG/2 mL 2 ML 1 $0.94
02-8213 Carmel Fire Department Lidocaine HCL INJ-SYRNG 100 MG LIDOCAINE HCL INJ-SYRNG 100 MG 5 ML 1 $4.30
02-8213 Carmel Fire Department Lidocaine HCL JELLY 2%30 GM LIDOCAINE JELLY 2%JELLY 2%30 GM 30 1 $5.63
02-8213 Carmel Fire Department Magnesium SULF INJ 1000 MG/2 mL MAGNESIUM SULFATE INJ 1000 MG/2 mL 2 ML 2 $1.56
02-8213 Carmel Fire Department Naloxone INJ 1 MG/ML NALOXONE HYDROCHLORIDE INJ 1 MG/ML 2 ML 3 $84.33
02-8213 Carmel Fire Department Nitroglycerin Tab 0.4 MG NITROSTAT TAB 0.4 MG 100 ea 7 $154.84
02-8213 Carmel Fire Department Ondansetron INJ 2 mg/mL ONDANSETRON INJ 2 mg/mL 2 ML 16 $5.60
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 Racemic Epinephrine SOL 2.25%UD S-2 INHALANT SOL 2.25%UD 0.5 ML 17 $19.55
02-8213 Carmel Fire Department Sodium Bicarbonate INJ 7.5% SODIUM BICARBONATE INJ 7.5% 50 ML 2 $20.88
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 1 $0.76
$1,171.69