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Home My WebLink About303546 09/26/16 ♦1�r'C4q'yP CITY OF CARMEL, INDIANA VENDOR: 360209 ONE CIVIC SQUARE ST VINCENT HOSPITAL CHECK AMOUNT: $w 2,623.53 CARMEL, INDIANA 46032 ATTN;KATREENA SHIREY CHECK NUMBER: 303546 vM, 10330 N MERIDIAN ST SUITE 430 CHECK DATE: 09/26/16 INDIANAPOLIS IN 46290 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 102 4239011 13830 2,623.53 SPECIAL DEPT SUPPLIES VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) ST VINCENT HOSPITAL ALLOWED 20 ACCOUNTS PAYABLE VOUCHER ATTN:KATREENA SHIREY IN SUM OF$ 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. $2,623.53 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 13830 42-390.11 $2,623.53 1 hereby certify that the attached invoice(s),or 9/21/16 13830 $2,623.53 1120 102—.-D 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 Wednesday, September 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 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 8/31/2016 13830 BILL TO Carmel Fire EMS Attn: Denise Snyder 2 Carmel Civic Square Carmel, IN 46032 TERMS Due on receipt DESCRIPTION AMOUNT EMS Supplies purchased August 2016 2,623.53 Medical Supplies -July 1,143.53 Medical Supplies-August 754.40 897.93 Transfer Drugs - August 725.60 Total August due: $2,623.53 46029-160085-65050. Please note invoice number Total $29623.53 that you are paying on check/stub. Thank you! Inquiries: Carolyn Terry Payments/Credits $0.00 CMTerry@stvincent.org Balance Due $29623.53 Depatmental Transfer of Supplies date Jul-16 Requesting Department: Carmel Fire Dept Supplying Department ER Business Unit and Department 4602431600 QUANTITY UNIT COST TOTAL COST Alcohol preps 10 $1.96 $19.60 Angiocath 14g $1.58 $0.00 Angiocath 16g $1.58 $0.00 Angiocath 18g 51 $1.50 $76.50 Angiocath 20g 148 $1.50 $222.00 Angiocath 22g 8 $1.50 $12.00 Angiocath 24g 5 $1.55 $7.75 Basin kidney shaped $0.08 $0.00 Basin round 1 $0.31 $0.31 Ca no- Line Sampling ETCO2 Smart Ped per bx $287.50 $0.00 Ca no-Circuit Nasal with Tubing Adult per cs $312.50 $0.00 Capno-St filter lin Adlt/ped 1 case $940.00 $0.00 Coban 1' Roll (ea) $1.75 $0.00 Cold paks 10 $0.57 - $5.70 EKG Electrodes $3.12 $0.00 Emesis Bags (per pack) 1 $11.52 $11.52 EZ-10 Adult Needles ($495.00/box of 5) $99.00 $0.00 Foam-Quikcare $2.67 $0.00 Guaze,2 x 2 Cotton bpil 1 $1.88 $1.88 Guaze, 2 X 2 Sterile 1 $0.02 $0.02 Gauze 4 X 3 sponge (per box 1 $1.24 $1.24 Gauze 4 x 4 tub $0.32 $0.00 Gauze Kerlex 23 $0.67 $15.41 Gloves-Med $10.35 $0.00 Gloves- Large $10.35 $0.00 Gloves-Xlarge $10.35 $0.00 IV Adapter, Luerlock 30 $0.15 $4.50 IV Dial a flow 3.151 $0.00 IV Extension 19" $1.91 $0.00 IV Lock with Ext 80 $1.87 $149.60 IV Start Kits ea 122 $2.88 $351.36 IV Start Kits Sobraview(100/bx) 60 $2.66 $159.60 IV Tubing 15gtt, 55 $1.17 $64.35 KY pkt $0.10 $0.00 Kerlix 4.5"x6ply $0.73 $0.00 Lancets per box $50.00 $0.00 Largyngsco a Blades Stat 3 box $135.74 $0.00 Largyngsco a Blades Stat 4 box $135.74 $0.00 Microdot Xtra Test Strips $29.98 $0.00 Microdot Xtra Control Solutions $14.95 $0.00 Normal Saline 1000 cc bags/ca $9.48 $0.00 Razor, disposeable $0.12 $0.00 Sca el#11 1.301 $0.00 Sharps Container $4.59 $0.00 Sterile H2O bottle $0.71 $0.00 Suction Canister&top $3.26 $0.00 Suture Kit 1 $1.09 $0.00 Syringe w/Needle 1 ml 5 $0.07 $0.35 Syringe w/Needle 3 ml $0.05 $0.00 Syringe w/Needle 3 ml per case $35.70 $0.00 Syringe w/Needle 5ml $0.10 $0.00 Syringe w/Needle 10 ml $0.12 $0.00 Syringe w/Needle 10 ml per case $41.92 $0.00 Syringe w Saline 3ml 0.281 $0.00 Syringe w/Salinel0ml $0.32 $0.00 10 ml saline vials(per box) 3 $9.63 $28.89 Ta e 2" 6 rolls/box) $1.00 $2.00 Ta e V 2 $0.50 $2.50 --------- Tape 2"cloth adh 5 $1.29 $6.45 Tape Transpore 1/2" $1.28 $0.00 TB ET Cuffed Rediture $1.80 $0.00 Warm paks $1.46 $0.00 Wound Cleanser $5.04 $0.00 Yankauers $0.34 $0.00 Ambu Bag w/mask-Adult $14.63 $0.00 Ambu Bag w/mask-Adult cs/10 $146.30 $0.00 Ambu Ba w/mask-Peds cs/10 $126.00 $0.00 Ambu Bag w/mask-Infant cs/10 $16.00 $0.00 CPAP mask- 1 case/10 $919.99 $0.00 Lg Bitrac Full Face Mask $29.00 $0.00 ET Tube Stylette $0.00 ,Wipes Disenfect $11.52 $0.00 Grand Total $1,143.53 Approved by date Depatmental Transfer of Supplies date Aug-16 Requesting Department: Carmel Fire Dept Supplying Department ER Business Unit and Department 4602431600 QUANTITY UNIT COST TOTAL COST Alcohol preps 1 $1.96 $1.96 Angiocath 14 $1.58 $0.00 Angiocath 16 $1.58 $0.00 Angiocath 18g 40 $1.50 $60.00 Angiocath 20g 69 $1.50 $103.50 Angiocath 22g 8 $1.50 $12.00 Angiocath 24 $1.55 $0.00 Basin kidney shaped $0.08 $0.00 Basin round $0.31 $0.00 Capno- Line Sampling ETCO2 Smart Ped per bx $287.50 $0.00 Ca no-Circuit Nasal with Tubing Adult per cs $312.50 $0.00 Ca no-St filter lin Adlt/ ed 1 case $940.00 $0.00 Coban 1' Roll (ea) $1,75 $0.00 Cold paks 6 $0.57 $3.42 EKG Electrodes $3.12 $0.00 Emesis Bags(per pack) $11.52 $0.00 EZ-10 Adult Needles $495.00/box of 5 $99.00 $0.00 Foam-Quikcare 1 $2.67 $2.67 Guaze, 2 x 2 Cotton bail $1.88 $0.00 Guaze, 2 X 2 Sterile 1 $0.02 $0.02 Gauze 4 X 3 sponge (per box) $1.24 $0.00 Gauze 4 x 4 tub 6 $0.32 $1.92 Gauze Kerlex 13 $0.67 $8.71 Gloves-Med $10.35 $0.00 Gloves-Large $10.35 $0.00 Gloves-Marge $10.35 $0.00 IV Adapter, Luerlock 6 $0.15 $0.90 IV Dial a flow $3.15 $0.00 IV Extension 19" 25 $1.91 $47.75 IV Lock with Ext 68 $1.87 $127.16 IV Start Kits ea 17 $2.88 $48.96 IV Start Kits Sobraview(100/bx) 86 $2.66 $228.76 IV Tubing 15 tt 45 $1.17 $52.65 KY pkt $0.10 $0.00 Kerlix 4.5"x6ply $0.73 $0.00 Lancets per box $50.00 $0.00 Largyngsco a Blades Stat 3 box $135.74 $0.00 Largyngsco a Blades Stat 4 box $135.74 $0.00 Microdot Xtra Test Strips $29.98 $0.00 Microdot Xtra Control Solutions $14.95 $0.00 Normal Saline 1000 cc bags/ca $9.48 $0.00 Razor, dis oseable $0.12 $0.00 Sca el#11 $1.30 $0.00 Sharps Container $4.59 $0.00 Sterile H2O bottle $0.71 $0.00 Suction Canister&top $3.26 $0.00 Suture Kit 1 $1.09 $0.00 Syringe w/Needle 1 ml $0.07 $0.00 Syringe w/Needle 3 ml $0.05 $0.00 Syringe w/Needle 3 ml per case $35.70 $0.00 Syringe w/Needle 5ml $0.10 $0.00 Syringe w/Needle 10 ml $0.12 $0.00 Syringe w/Needle 10 ml per case $41.92 $0.00 Syringe w Saline 3ml $0.28 $0.00 Syringe w/Saline10ml $0.32 $0.00 10 ml saline vials (per box) 5 $9.63 $48.15 Tape 2"(6 rolls/box) $1.00 $0.00 Tape 1" 4 $0.501 $2.00 Tape 2" cloth adh 3 $1.29 $3.87 Tape Trans ore 1/2" $1.28 $0.00 TB ET Cuffed Rediture $1.80 $0.00 Warm paks $1.46 $0.00 Wound Cleanser $5.04 $0.00 Yankauers $0.34 $0.00 Ambu Bag w/mask-Adult $14.63 $0.00 Ambu Bag w/mask-Adult cs/10 $146.30 $0.00 Ambu Bag w/mask-Peds cs/10 $126.00 $0.00 Ambu Bag w/mask- Infant cs/10 $16.00 $0.00 CPAP mask- 1 case/10 $919.99 $0.00 Lg Bitrac Full Face Mask $29.00 $0.00 ET Tube Stylette $0.00 Wipes Disenfect $11.52 $0.00 Grand Total $754.40 Approved by date Control Controll Control Contr(Totall'TotalPicl 02-8213 Carmel Fire Department ADENOSINE INJ 6 MG ADENOSINE INJ 6 MG 2 ML 6.00 13.50 02-8213 Carmel Fire Department Albuterol SULF NEB SOL(0.083%) ALBUTEROL SULFATE 0.083% NEB SOL(0.083%) 3 ML 34.00 5.44 02-8213 Carmel Fire Department Aspirin Tab Chew 81 MG ASPIRIN Tab Chew 81 MG 750 EA 36.00 0.72 02-8213 Carmel Fire Department Dextrose INJ-SYRNG 50% DEXTROSE INJ-SYRNG 50% 50 mL 10.00 85.50 02-8213 Carmel Fire Department DiphenhydrAMINE INJ 50 MG/mL DIPHENHYDRAMINE HYDROCHLORIDE INJ 50 MG/mL 1 ML 2.00 1.12 02-8213 Carmel Fire Department EpiNEPHrine HCL INJ 0.1 MG/ML EPINEPHRINE HCL INJ 0.1 MG/ML 10 ML 20.00 81.40 02-8213 Carmel Fire Department Epinephrine INJ 1 MG/ML EpiNEPHrine INJ 1 MG/ML 30 ML 1.00 2.54 02-8213 Carmel Fire Department FentaNYL INJ 100 MCG/2 mL FENTANYL CITRATE INJ 100 MCG/2 mL 2 ML 34.00 25.50 02-8213 Carmel Fire Department Glucagon INJ 1 MG GLUCAGEN DIAG. KIT INJ 1 MG 1 EA 3.00 298.92 02-8213 Carmel Fire Department Ketorolac INJ 60 MG/2 mL KETOROLAC TROMETHAMINE INJ 60 MG/2 mL 2 ML 3.00 2.82 02-8213 Carmel Fire Department Lidocaine HCL INJ-SYRNG 100 MG LIDOCAINE HCL INJ-SYRNG 100 MG 5 ML 2.00 8.60 02-8213 Carmel Fire Department Lidocaine HCL JELLY 2%30 GM LIDOCAINE JELLY 2%JELLY 2%30 GM 30 1.00 5.63 02-8213 Carmel Fire Department MethylPREDNISolone NA Succ INJ 125 MG SOLD-MEDROL INJ 125 MG 2 ML 2.00 10.68 02-8213 Carmel Fire Department MIDAZOLAM INJ 10 MG/2 mL MIDAZOLAM HCL INJ 10 MG/2 mL 2 ML 1.00 0.84 02-8213 Carmel Fire Department Naloxone INJ 1 MG/ML NALOXONE HYDROCHLORIDE INJ 1 MG/ML 2 ML 1.00 28.11 02-8213 Carmel Fire Department Nitroglycerin Tab 0.4 MG NITROSTAT TAB 0.4 MG 100 ea 4.00 88.48 02-8213 Carmel Fire Department Ondansetron INJ 2 mg/mL ONDANSETRON INJ 2 mg/mL 2 ML 18.00 6.18 02-8213 Carmel Fire Department Ondansetron Tab ODT 4 MG ONDANSETRON Tab ODT 4 MG 30 EA 14.00 2.24 02-8213 Carmel Fire Department predniSONE Tab 20 MG PREDNISONE Tab 20 MG 100 EA 12.00 1.68 02-8213 Carmel Fire Department Racemic Epinephrine SOL 2.25% UD S-2 INHALANT SOL 2.25% UD 0.5 ML 2.00 2.82 02-8213 Carmel Fire Department Sodium Chloride INJ 0.9%1000 mL SODium CHLORide 0.9% INJ 0.9% 1000 mL 1000 ML 50.00 39.50 02-8213 Carmel Fire Department Sodium Chloride INJ 0.9%50 mL SODium CHLORide 0.9% INJ 0.9%50 mL 50 ML 3.00 6.54 02-8213 Carmel Fire Department Sodium Chloride INJ 0.9%500 mL SODium CHLORide 0.9% INJ 0.9%500 mL 500 ML 9.00 6.84 725.60 I I