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Home My WebLink About305669 11/28/16 CITY OF CARMEL, INDIANA VENDOR: 360209 ONE CIVIC SQUARE ST VINCENT HOSPITAL CHECK AMOUNT: $*****2,297.44* CARMEL, INDIANA 46032 ATTN:KATREENA SHIREY CHECK NUMBER: 305669 10330 N MERIDIAN ST SUITE 430 CHECK DATE: 11/28/16 INDIANAPOLIS IN 46290 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 102 4239011 13846 2,297.44 SPECIAL DEPT SUPPLIES VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) ST VINCENT HOSPITAL ALLOWED 20 ACCOUNTS PAYABLE VOUCHER ATTN:KATREENA SHIREY IN SUM OF$ 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. $2,297.44 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 13846 42-390.11 $2,297.44 1 hereby certify that the attached invoice(s),or 11/21/16 13846 $2,297.44 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 Monday, November 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 5-11-10-1.6 120- 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 11/14/2016 13846 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 2016 2,297.44 Medical Supplies -October 1,078.43 Transfer Drugs - October 1,219.01 Total Ocdtober due: $2,297.44 46029-160085-65050. Please note invoice number Total $29297.44 that you are paying on checklstub. Thank you! Inquiries: Carolyn Terry Payments/Credits $0.00 CMTerry@stvincent.org [Balance Due $29297.44 Control Controll Control Contro12 TotalPic TotalPic1 02-8213 Carmel Fire Department Acetaminophen Tab 325 MG TYLENOL Tab 325 MG 3000 EA 35.00 0.35 02-8213 Carmel Fire Department ADENOSINE INJ 6 MG ADENOSINE INJ 6 MG 2 ML 11.00 24.75 02-8213 Carmel Fire Department Albuterol SULF NEB SOL(0.083%) ALBUTEROL SULFATE 0.083% NEB SOL(0.083%) 3 ML 31.00 4.96 02-8213 Carmel Fire Department AMIODARONE HCL INJ 50 MG/mL AMIODARONE HYDROCHLORIDE INJ 50 MG/mL 3 ML 2.00 1.56 02-8213 Carmel Fire Department Aspirin Tab Chew 81 MG ASPIRIN Tab Chew 81 MG 750 EA 144.00 2.88 02-8213 Carmel Fire Department Atropine Sulfate INJ-SYRNG 1 MG/10 mL ATROPINE SULFATE INJ-SYR 1 MG/10 mL 10 ML 8.00 61.52 02-8213 Carmel Fire Department Bacitracin OIN 500 Units/GM Pkt BACITRACIN OIN 500 Units/GM Pkt 0.9GM 144.00 24.48 02-8213 Carmel Fire Department Dextrose-DOPamine INJ 400 MG/250 mL DEXTROSE/DOPamine HCL INJ 400 MG/250 mL 250 ML 1.00 6.23 02-8213 Carmel Fire Department Dextrose INJ-SYRNG 50% DEXTROSE INJ-SYRNG 50% 50 mL 1.00 8.55 02-8213 Carmel Fire Department DiphenhydrAMINE INJ 50 MG/mL DIPHENHYDRAMINE HYDROCHLORIDE INJ 50 MG/mL 1 ML 1.00 0.56 02-8213 Carmel Fire Department EpiNEPHrine HCL INJ 0.1 MG/ML EPINEPHRINE HCL INJ 0.1 MG/ML 10 ML 21.00 85.47 02-8213 Carmel Fire Department Epinephrine INJ 1 MG/ML EpiNEPHrine INJ 1 MG/ML 30 ML 2.00 5.08 02-8213 Carmel Fire Department Glucagon INJ 1 MG GLUCAGEN DIAL.KIT INJ 1 MG 1 EA 4.00 429.41 02-8213 Carmel Fire Department Glucose(Dextrose)GEL 40% GLUTOSE 15 GEL 40% 15 GM 6.00 34.86 02-8213 Carmel Fire Department Ipratropium SOL 0.02% IPRATROPIUM BROMIDE SOL 0.02% 2.5 ML 23.00 3.22 02-8213 Carmel Fire Department Ketorolac INJ 60 MG/2 mL KETOROLAC TROMETHAMINE INJ 60 MG/2 mL 2 ML 2.00 1.88 02-8213 Carmel Fire Department Lidocaine HCL INJ-SYRNG 100 MG LIDOCAINE HCL INJ-SYRNG 100 MG 5 ML 24.00 103.20 02-8213 Carmel Fire Department Lidocaine HCL JELLY 2%30 GM LIDOCAINE JELLY 2%JELLY 2%30 GM 30 1.00 5.94 02-8213 Carmel Fire Department Magnesium SULF INJ 1000 MG/2 mL MAGNESIUM SULFATE INJ 1000 MG/2 mL 2 ML 34.00 26.52 02-8213 Carmel Fire Department MethyIPREDNISolone NA Succ INJ 125 MG SOLU-MEDROL INJ 125 MG 2 ML 1.00 5.34 02-8213 Carmel Fire Department Naloxone INJ 1 MG/ML NALOXONE HYDROCHLORIDE INJ 1 MG/ML 2 ML 9.00 252.99 02-8213 Carmel Fire Department Nitroglycerin Tab 0.4 MG NITROSTAT TAB 0.4 MG 100 ea 3.00 66.36 02-8213 Carmel Fire Department Ondansetron INJ 2 mg/mL ONDANSETRON INJ 2 mg/mL 2 ML 22.00 7.04 02-8213 Carmel Fire Department Ondansetron Tab ODT 4 MG ONDANSETRON Tab ODT 4 MG 30 EA 9.00 1.44 02-8213 Carmel Fire Department predniSONE Tab 20 MG PREDNISONE Tab 20 MG 100 EA 47.00 6.58 02-8213 Carmel Fire Department Racemic Epinephrine SOL 2.25%UD S-2 INHALANT SOL 2.25% UD 0.5 ML 15.00 21.15 02-8213 Carmel Fire Department Sodium Chloride INJ 0.9% 1000 mL SODium CHLORide 0.9% INJ 0.9% 1000 mL 1000 ML 19.00 15.01 02-8213 Carmel Fire Department Sodium Chloride INJ 0.9%50 mL SODium CHLORide 0.9%INJ 0.9%50 mL 50 ML 6.00 10.92 02-8213 Carmel Fire Department Sodium Chloride INJ 0.9%500 mL SODium CHLORide 0.9% INJ 0.9%500 mL 500 ML 1.00 0.76 627.00 1,219.01 i ------------- Depatmental Transfer of Supplies date submissed 11/02/16 Requesting Department: Carmel Fire Dept Supplying Department ER Oct-16 Cost Center Cost Center 27230 QUANTITY UNIT COST TOTAL COST Alcohol preps 3 $1.96 $5.88 Angiocath 18g 45 $1.50 $67.50 Angiocath 20g 97 $1.50 $145.50 Angiocath 20g 1.88 per box $95.00 $0.00 Angiocath 22g 23 $1.50 $34.50 Angiocath 24g $1.55 $0.00 Basin kidney shaped $0.08 $0.00 Basin round $0.31 $0.00 Ca no-Line Sampling ETCO2 Smart Ped per bx $287.50 $0.00 Ca no-Circuit Nasal with Tubing Adult 1 $312.50 $312.50 Ca no-St filter lin Adlt/ ed 1 case $204.00 $0.00 Coban V Roll ea $1.75 $0.00 Cold paks $0.57 $0.00 EKG Electrodes $3.12 $0.00 Emesis Bags(perpack) 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 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 $0.32 $0.00 Gauze Kerlex $0.67 $0.00 Gloves-Med $10.35 $0.00 Gloves- Large $10.35 $0.00 Gloves-Xlar a $10.35 $0.00 Hover Mat IV Adapter, Luerlock $0.15 $0.00 IV Dial a flow $3.15 $0.00 IV Extension 19" $1.91 $0.00 IV Lock with Ext 88 $1.87 $164.56 IV Start Kits ea 78 $2.88 $224.64 IV Start Kits Sobraview(100/bx) 20 $2.66 $53.20 IV Tubing 15 tt 15 $1.17 $17.55 Kerlix 4.5"x6ply $0.73 $0.00 Largyngscope Blades Stat 3 box $180.50 $0.00 Largyngscope Blades Stat 4 box $135.74 $0.00 Microdot Xtra Test Strips $24.95 $0.00 Microdot Xtra Control Solutions $12.00 $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 1 $3.26 $3.26 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 0.25 $35.76 $8.94 Syringe w/Needle 5ml $0.10 $0.00 Syringe w/Needle 10 ml $0.12 $0.00 Syringe w Saline 3ml $0.28 $0.00 Syringe w/Salinel0ml 30 $0.32 $9.60 10 ml saline vials(per box 2 $9.63 $19.26 Tape 2" 6 rolls/box $1.00 $0.00 Tape 1" $0.50 $0.00 Tape 2"cloth adh $1.29 $0.00 Tape Transpore 1/2" $1.28 $0.00 TB ET Cuffed Rediture $1.801 $0.00 Warm paks $1.46 $0.00 Wound Cleanser $5.04 $0.00 Suction Canister&to $3.26 $0.00 Yankauers $0.34 $0.00 Ambu Ba w/mask-Adult $14.63 $0.00 Ambu Ba w/mask-Adult cs/10 $146.30 $0.00 Ambu.Ba w/mask- Peds cs/10 $126.00 $0.00 Ambu Ba 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 Stylefte $0.00 Wipes Disenfect $11.52 $0.00 Grand Total $1,078.43 Approved by date