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Home My WebLink About308663 02/28/17 CITY OF CARMEL, INDIANA VENDOR: 360209. 4� R ® ONE CIVIC SQUARE ST VINCENT HOSPITAL CHECK AMOUNT: $*****6,408.22* ?� CARMEL, INDIANA 46032 ATTN:CAROLYN N MERIDIAN ST SUITE 430TNG CHECK NUMBER: 308663 TERRY ACCT. CHECK DATE: 02/28/17 INDIANAPOLIS IN 46290 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 102 4239011 13886 6,408.22 SPECIAL DEPT SUPPLIES VOUCHER NO. WARRANT NO. IPrescribed by State Board of Accounts City Form No.201(Rev.1995) Vendor# 360209 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER ST VINCENT HOSPITAL IN SUM OF$ CITY OF CARMEL ATTN:CAROLYN TERRY ACCT. RPTNG 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. INDIANAPOLIS, IN 46290 Payee $6,408.22 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 13886 42-390.11 $6,408.22 1 hereby certify that the attached invoice(s),or 2/17/17 13886 $6,408.22 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 Friday, February 17,2017 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 1/31/2017 13886 BILL TO Carmel Fire EMS Attn: Denise Snyder 2 Carmel Civic Square Carmel, IN 46032 TERMS Due on receipt DESCRIPTION AMOUNT EMS Supplies purchased January 2017 6,408.22 Medical Supplies December. - $1,099.05 Medical Supplies January - 2,686.60 Drugs transfer January- 2,622.57 Total January-due: $6,468.22 46029-160085-65050. Please note invoice number Total $69408.22 that you are paying on check/stub. Thank you! Inquiries: Carolyn Terry Payments/Credits $0.00 CMTerry@stvincent.org Balance Due $69408.22 Depatmental Transfer of Supplies date submissed 12/11/16 Requesting Department: Carmel Fire Dept Supplying Departmem ER Dec-16 Cost Center Cost Center 27230 QUANTITY UNIT COST COST Alcohol preps $1.96 $0.00 Angiocath 16g 10 $1.56 $15.60 Angiocath 18g 20 $1.50 $30.00 Angiocath 20g 90 $1.50 $135.00 Angiocath 20g 1.88 per box $95.00 $0.00 Angiocath 22g 15 $1.50 $22.50 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 per cs $312.50 $0.00 Capno-St filter lin Adlt/ ed 1 case $204.00 $0.00 Coban 1' Roll ea $1.75 $0.00 Cold paks $0.57 $0.00 EKG Electrodes 20 $3.12 $62.40 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 bail $1.88 $0.00 Guaze,2 X 2 Sterile $0.02 $0.00 Gauze 4 X 3 sponge per box) 1 $1.24 $1.24 Gauze 4 x 4 tub $0.32 $0.00 Gauze Kerlex 10 $0.67 $6.70 Gloves-Med $10.35 $0.00 Gloves-Large $10.35 $0.00 Gloves-Marge $10.35 $0.00 Hover Mat IV Adapter, Luerlock 20 $0.15 IV Dial a flow $3.15 $0.00 IV Extension 19" 5 1.911 $9.55 IV Lock with Ext 108 $9.87 $201.96 IV Start Kits ea 96 $2.88 $276.48 IV Start Kits Sobraview 100/bx 25 $2.66 $66.50 IV Tubing 10gtt 21 $1.17 $24.57 Kerlix 4.5"x6ply $0.73 $0.00 Lancets per box 3 $57.78 $173.34 Larg n sco a 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, disposeable $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&to $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 5 $0.05 $0.25 S do a w/Needle 3 ml per case $35.76 $0.00 Syringe w/Needle 5ml $0.10 $0.00 Syringe w/Needle 10 ml $0.12 $0.00 Syringe 30ml 2 $0.42 $0.84 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" 6 1 $0.501 $3.00 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 Suction Canister&top $3.26 $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 $480.00 $0.00 Lg Bitrac Full Face Mask $29.00 $0.00 ET Tube Stylefte $0.00 Wi es Disenfect $11.52 $0.00 Grand Tota $1,099.05 Approved by date Depatmental Transfer of Supplies date submissed 02/02/17 Requesting Department: Carmel Fire Dept Supplying Departmen ER Jan-17 Cost Center Cost Center 27230 QUANTITY UNIT COST TOTAL COST Alcohol preps 20 $1.96 $39.20 Angiocath 16g $1.56 $0.00 Angiocath 18g 30 $1.50 $45.00 Angiocath 20g 105 $1.50 $157.50 Angiocath 20g 1.88 per box $95.00 $0.00 Angiocath 22g 20 $1.50 $30.00. Angiocath 24g $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-Circuit Nasal with Tubing Adult per cs(100) 1 $940.00 $940.00 Capno-St filter lin Adlt/ped 1 case $204.00 $0.00 Coban 1' Roll (ea) $1.75 $0.00 Cold paks 8 $0.57 $4.56 EKG Electrodes $3.12 $0.00 Emesis Bags(per pack) 2 $11.52 $23.04 EZ-10 Adult Needles($495.00/box of 5) $99.00 $0.00 Foam-Quikcare $2.671 $0.00' Guaze, 2 x 2 Cotton bail $1.88 $0.00 Guaze, 2 X 2 Sterile $0.02 $0.00 Gauze 4 X 3 sponge (per box) $1.24 $0.00 Gauze 4 x 4 tub 17 $0.32 $5.44 Gauze Kerlex 4 $0.67 $2.68 Gloves-Med $10.35 $0.00 Gloves-Large 3 $10.35 $31.05 Gloves-Marge $10.35 $0.00 IV Adapter, Luerlock 35 $0.15 $5.25 IV Dial a flow $3.15 $0.00 IV Extension 19" $1.91 $0.00 IV Lock with Ext 92 $1.87 $172.04 IV Start Kits ea 150 $2.88 $432.00 IV Start Kits Sobraview(100/bx) 15 $2.66 $39.90 IV Tubing 10 tt 34 $1.17 $39.78 Kerlix 4ff'x6ply $0.73 $0.00 Lancets per box 1 $57.78 $57.78 Larg n sco a Blades Stat 3 box $180.50 $0:00 Largyngscope Blades Stat 4 box $135.74 $0.00 Microdot Xtra Test Strips 20 $29.98 $599.60 Microdot Xtra Control Solutions $12.00 $0.00 Normal Saline 1000 cc bags/ca $9.48 $0.00 Razor, disposeable $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 $35.76 $0.00 Syringe w/Needle 5ml $0.10 $0.00 Syringe w/Needle 10 ml $0.12 $0.00 Syringe 30ml $0.42 $0.00 Syringe w Saline 3ml $0.28 $0.00 Syringe w/Saline10ml $0.32 $0.00 10 ml saline vials (per box) 6 1 $9.631 $57.78 Ta a 2" 6 rolls/box) 2 1 $1.001 $2.00 Tae 1" 4 1 $0.501 $2.00 Tape 2"cloth adh $1.29 $0.00 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 Suction Canister&to $3.26 $0.00 Yankauers $0.34 $0.00 Ambu Bag w/mask-Adult $14.63 $0.00 Ambu Ba 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 $480.00 $0.00 Lg Bitrac Full Face Mask $29.00 $0.00 ET Tube Stylette $0.00 Wipes Disenfect $11.52 $0.00 Grand Total $2,686.60 'Approved by date Control Controll Control Contro12 TotalPic TotalPicl 02-8213 Carmel Fire Department Acetaminophen Tab 325 MG TYLENOL Tab 325 MG 3000 EA 6.00 $0.06 02-8213 Carmel Fire Department ADENOSINE INJ 6 MG ADENOSINE INJ 6 MG 2 ML 17.00 $38.25 02-8213 Carmel Fire Department Albuterol SULF NEB SOL(0.083%) ALBUTEROL SULFATE 0.083%NEB SOL(0.083%) 3 ML 77.00 $12.08 02-8213 Carmel Fire Department Albuterol-Ipratropium SOL 3 MG-0.5 MG/3 ML IPRATROPIUM-ALBUTEROL SOL 3 MG-0.5 MG/3 ML 3 ml 7.00 $1.54 02-8213 Carmel Fire Department AMIODARONE HCL INJ 50 MG/mL AMIODARONE HYDROCHLORIDE INJ 50 MG/mL 3 ML 13.00 $10.14 02-8213 Carmel Fire Department Atropine Sulfate INJ-SYRNG 1 MG/10 mL ATROPINE SULFATE INJ-SYR 1 MG/10 mL 10 ML 35.00 $269.15 i 02-8213 Carmel Fire Department CALcium CHLORide INJ-SYRNG 100 MG/mL CALcium CHLORide INJ-SYRNG 100 MG/mL 10 ML 2.00 $14.58 02-8213 Carmel Fire Department Dextrose INJ-SYRNG 50% DEXTROSE INJ-SYRNG 50% 50 mL 5.00 $42.75 02-8213 Carmel Fire Department DiphenhydrAMINE INJ 50 MG/mL DIPHENHYDRAMINE HYDROCHLORIDE INJ 50 MG/mL 1 ML 11.00 $6.16 02-8213 Carmel Fire Department EpiNEPHrine HCL INJ 0.1 MG/ML EPINEPHRINE HCL INJ 0.1 MG/ML 10 ML 46.00 $187.22 02-8213 Carmel Fire Department Glucagon INJ 1 MG GLUCAGON EMERGENCY KIT INJ 1 MG 1 EA 11.00 $1,233.32 02-8213 Carmel Fire Department Glucose(Dextrose)GEL 40% GLUTOSE 15 GEL 40% 15 GM 6.00 $34.86 02-8213 Carmel Fire Department Lidocaine HCL INJ-SYRNG 100 MG LIDOCAINE HCL INJ-SYRNG 100 MG 5 ML 1.00 $4.30 02-8213 Carmel Fire Department Lidocaine HCL JELLY 2%30 GM LIDOCAINE JELLY 2%JELLY 2%30 GM 30 3.00 $17.82 02-8213 Carmel Fire Department Magnesium SULF INJ 1000 MG/2 mL MAGNESIUM SULFATE INJ 1000 MG/2 mL 2 ML 4.00 $3.12 02-8213 Carmel Fire Department MethylPREDNISolone NA Succ INJ 125 MG SOLU-MEDROL INJ 125 MG 2 ML 2.00 $12.28 02-8213 Carmel Fire Department Naloxone INJ 1 MG/ML NALOXONE HYDROCHLORIDE INJ 1 MG/ML 2 ML 4.00 $112.44 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 NORepinephrine INJ 1 MG/mL LEVOPHED INJ 1 MG/mL 4 ML 25.00 $452.75 02-8213 Carmel Fire Department Ondansetron INJ 2 mg/mL ONDANSETRON INJ 2 mg/mL 2 ML 26.00 $8.32 02-8213 Carmel Fire Department Ondansetron Tab ODT 4 MG ONDANSETRON Tab ODT 4 MG 30 EA 31.00 $4.96 02-8213 Carmel Fire Department predniSONE Tab 20 MG PREDNISONE Tab 20 MG 100 EA 27.00 $3.78 02-8213 Carmel Fire Department Racemic Epinephrine SOL 2.25%UD S-2 INHALANT SOL 2.25%UD 0.5 ML 40.00 $56.40 02-8213 Carmel Fire Department Sodium Chloride INJ 0.9%1000 mL SODium CHLORide 0.9%INJ 0.9%1000 mL 1000 ML 30.00 $23.70 02-8213 Carmel Fire Department Sodium Chloride INJ 0.9%50 mL SODium CHLORide 0.9%INJ 0.9%50 mL 50 ML 1.00 $1.10 02-8213 Carmel Fire Department Sodium Chloride INJ 0.9%500 mL SODium CHLORide 0.9%INJ 0.9%500 mL 500 ML 3.00 $5.13 $2,622.57 1