HomeMy WebLinkAbout260318 06/28/16 ' C4q
*f CITY OF CARMEL, INDIANA VENDOR: 360209
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ONE CIVIC SQUARE ST VINCENT HOSPITAL CHECK AMOUNT: $*****1,437.50*
CARMEL, INDIANA 46032 ATTN:KATREENA SHIREY CHECK NUMBER: 260318
10330 N MERIDIAN ST SUITE 430 CHECK DATE: 06/28/16
INDIANAPOLIS IN 46290
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
102 4239011 13782 1,437.50 SPECIAL DEPT SUPPLIES
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995)
ST VINCENT HOSPITAL ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
ATTN:KATREENA SHIREY IN SUM OF$ CITY OF CARMEL
10330 N MERIDIAN ST SUITE 430 An invoice or bill to be properly itemized must show:kind of service,where performed,dates service
INDIANAPOLIS, IN 46290 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
$1,437.50 Payee
Purchase Order#
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Terms
Date Due
PO# ACCT# DATE INVOICE# DESCRIPTION
DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT
13782 42-390.11 $1,437.50 1 hereby certify that the attached invoice(s),or 6/21/16 13782 $1,437.50
1120 102 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
Tuesday,June 21,2016
David Haboush
Fire Chief
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—
Cost
20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer
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 5/31/2016 13782
BILL TO
Carmel Fire EMS
Attn: Denise Snyder
2 Carmel Civic Square
Carmel, IN 46032
TERMS
Due on receipt
DESCRIPTION AMOUNT
EMS Supplies purchased May 2016 1,437.50
Transfer Drugs $1;437.50
46029-160085-65050. Please note invoice number Total $19437.50
that you are paying on check/stub. Thank you!
Inquiries: Carolyn Terry PaymentsiCredits $0.00
CMTerry@stvincent.org Balance Due $19437.50
Control Controll Control Contro12 TotalPic TotalPicl
02-8213 Carmel Fire Department Acetaminophen Tab 325 MG TYLENOL Tab 325 MG 3000 EA 25 0.25
02-8213 Carmel Fire Department ADENOSINE INJ 6 MG ADENOSINE INJ 6 MG 2 ML 2 4.5
02-8213 Carmel Fire Department Albuterol SULF NEB SOL(0.083%) ALBUTEROL SULFATE 0.083%NEB SOL(0.083%) 3 ML 22 3.52
02-8213 Carmel Fire Department AMIODARONE HCL INJ 50 MG/mL AMIODARONE HYDROCHLORIDE INJ 50 MG/mL 3 ML 19 14.82
02-8213 Carmel Fire Department Aspirin Tab Chew 81 MG ASPIRIN Tab Chew 81 MG 750 EA 108 2.16
02-8213 Carmel Fire Department Atropine Sulfate INJ-SYRNG 1 MG/10 mL ATROPINE SULFATE INJ-SYR 1 MG/10 mL 10 ML 10 76.9
02-8213 Carmel Fire Department Dextrose-DOPamine INJ 400 MG/250 mL DEXTROSE/DOPamine HCL INJ 400 MG/250 mL 250 ML 9 56.07
02-8213 Carmel Fire Department Dextrose INJ-SYRNG 50% DEXTROSE INJ-SYRNG 50% 50 mL 6 51.3
02-8213 Carmel Fire Department DiphenhydrAMINE INJ 50 MG/mL DIPHENHYDRAMINE HYDROCHLORIDE INJ 50 MG/mL IML 5 2.8
02-8213 Carmel Fire Department EpiNEPHrine HCL INJ 0.1 MG/ML EPINEPHRINE HCL INJ 0.1 MG/ML 10 ML 17 69.19
02-8213 Carmel Fire Department Epinephrine INJ 1 MG/ML EpiNEPHrine INJ 1 MG/ML 30 ML 2 5.08
02-8213 Carmel Fire Department FentaNYL INJ 100 MCG/2 mL FENTANYL CITRATE INJ 100 MCG/2 mL 2 ML 16 12
02-8213 Carmel Fire Department Glucagon INJ 1 MG GLUCAGEN DIAG.KIT INJ 1 MG 1 EA 7 697.48
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 1 0.16
02-8213 Carmel Fire Department Ketorolac INJ 60 MG/2 mL KETOROLACTROMETHAMINE INJ 60 MG/2 mL 2 ML 4 3.76
02-8213 Carmel Fire Department Lidocaine HCL INJ-SYRNG 100 MG LIDOCAINE HCL INJ-SYRNG 100 MG 5 ML 2 8.6
02-8213 Carmel Fire Department Lidocaine HCL JELLY 2%30 GM LIDOCAINE JELLY 2%JELLY 2%30 GM 30 3 16.89
02-8213 Carmel Fire Department MethyIPREDNISolone NA Succ INJ 125 MG SOLU-MEDROL INJ 125 MG 2 ML 1 5.34
02-8213 Carmel Fire Department MIDAZOLAM INJ 10 MG/2 mL MIDAZOLAM HCL INJ 10 MG/2 mL 2 ML 8 6.72
02-8213 Carmel Fire Department Naloxone INJ 1 MG/ML NALOXONE HYDROCHLORIDE INJ 1 MG/ML 2 ML 9 252.99
02-8213 Carmel Fire Department Nitroglycerin Tab 0.4 MG NITROSTATTAB 0.4 MG 100 ea 3 66.36
02-8213 Carmel Fire Department Ondansetron INJ 2 mg/mL ONDANSETRON INJ 2 mg/mL 2 ML 23 8.05
02-8213 Carmel Fire Department Ondansetron Tab ODT 4 MG ONDANSETRON Tab ODT 4 MG 30 EA 20 3.2
02-8213 Carmel Fire Department predniSONE Tab 20 MG PREDNISONE Tab 20 MG 100 EA 2 0.32
02-8213 Carmel Fire Department Racemic Epinephrine SOL 2.25%UD S-2 INHALANT SOL 2.25%UD 0.5 ML 7 8.83
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 37 29.23
02-8213 Carmel Fire Department Sodium Chloride INJ 0.9%50 mL SODium CHLORide 0.9%INJ 0.9%50 mL 50 ML 2 4.36
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
1437.5