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311219 05/09/17
CITY OF CARMEL, INDIANA VENDOR: 360209 ONE CIVIC SQUARE ST VINCENT HOSPITAL CHECK AMOUNT: $*****4,066.20* CARMEL, INDIANA 46032 ATTN:CAROLYN TERRY ACCT.RPTNG CHECK NUMBER: 311219 M `• 10330 N MERIDIAN ST SUITE 430 ON CHECK DATE: 05/09/17 INDIANAPOLIS IN 46290 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 102 4239011 13914 4,066.20 SPECIAL DEPT SUPPLIES > $ < « / § / / / 7 / 0 / kZ % O E �_ r ® 0 2 < k 7 5 z 3 o O 7 \ 0 a 7 a % CO D N m n0 # � m # ■ -n # q q $ > } ) k / / \ § -n > / / / § / k \ b m 3 = © a CL Rk z § k 2 / « > O % a o O m § ( 7 0 ¥ % _ J $ a 7 r- e % $ g W M [ 0 % i g i / $ 0 i CD . CDA 0 CD A § - k k O I \ f CL i § - C ® - / ƒ % ( \ \ CD 0 0 m k 0 0 \ CL k E % / - \ 3 e � e [ , - e , ƒ %« , m q § ca. S, kƒ / § ) \ \ ; ; J CL 2$ #\ ) / # § \ � z CD� � / � & c o - [} k2 k ƒ \ C a � 0 ^ D 3 0> rl) ii k k } _ � 3 -0 0 % Ul w D }_ƒ ( \ > §/ } o 6� g3 � 2 0 3 . G n \ 0 E_ / \ \ O f , Z § % C c � / % m / § m / A n = o CL 0 CL / CD CL ] M / / / § C k « i \_ $ 2 / } \ 0 0 { \ § ° \ 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 4/20/2017 13914 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 2017 4,066.20 Medical Supplies March - 3,279.41 Drugs transfer March- 786.79 Total March due: $4,066.20 46029-160085-65050. Please note invoice number Total $49066.20 that you are paying on check/stub. Thank you! 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L) N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N 0 0 0 O O O O O O O O O O O O O O O O O O O O O O O O O O O Depatmental Transfer of Supplies date submissed 03103/17 Requesting Department: Carmel Fire Dept Supplying Department ER Mar-17 Cost Center Cost Center 27230 QUANTITY UNIT COST TOTAL COST Alcohol preps $0.25 $0.00 Angiocath 14 $1.58 $0.00 Angiocath 16 $1.56 $0.00 Angiocath 18g 10 $1.50 $15.00 Angiocath 20g 75 $1.50 $112.50 Angiocath 20g 1.88 per box $95.00 $0.00 Angiocath 22 $1.50 $0.00 Angiocath 2 $1.55 $0.00 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 Ca no-Circuit Nasal with Tubing Adult per cs 100 $940.00 $0.00 Ca no-St filter lin Adlt/ ed 1 case $356.30 $0.00 Coban 1'Roll ea $1.75 $0.00 Cold paks $0.57 $0.00 Drill Driver Power EZ-10 $295.00 $0.00 EKG Electrodes $3.12 $0.00 Emesis Bas(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 3 $0.02 $0.06 Gauze 4 X 3 sponge(per box $1.24 $0.00 Gauze 4 x 4 tub 5 $0.32 $1.60 Gauze Kerlex $0.67 $0.00 Gloves-Med $10.35 $0.00 Gloves-Large $10.35 $0.00 Gloves-Marge $ 0.351 $0.00 IV Adapter,Luerlock 10 $0.151 $1.50 IV Dial a flow $3.151 $0.00 IV Extension 19" 20 $1.911 $38.20 IV Lock with Ext 95 $1.87 $177.65 IV Start Kits ea 85 $2.88 $244.80 IV Start Kits Sobraview 100/bx 20 $2.66 $53.20 IV Tubing 10 tt 35 $1.17 $40.95 Kerlix 4.5"x6ply $0.73 $0.00 Lancets per box $57.78 $0.00 Largyngscope Blades Stat 3 box $180.50 $0.00 Largyngscope Blades Stat 4 box $135.74 $0.00 Microdot Xtra Test Strips $29.98 $0.00 Microdot Xtra Control Solutions $12.00 $0.00 Normal Saline 1000 cc bags/ca $9.48 $0.00 Pulse Ox,Adult 3 $5.18 $15.54 Pulse Ox,Peds 3 5.171 $15.51 Razor,dis oseable $0.121 0.00 Sca el#11 $1.301 0.00 Sharps Container $4.591 $0.00 Sterile H2O bottl0.711 $0.00 Suction Canister&to $3.26 $0.00 Suture Kit 1 $1.09 $0.00 SYR Hypo wheedle $0.25 $0.00 Syringe wheedle 1 ml 10 $0.07 $0.70 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 30 $0.32 $9.60 10 ml saline vials(per box 5 $9.631 $48.15 Tape 2" 6 rolls/box $1.001 0.00 Tae 1" $0.501 $0.00 Tape 2"Goth adh $1.29 $0.00 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 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 Flow-Safe!!Ez $443.95 $0.00 CPAP mask-1 case/10 $480.00 $0.00 CPAP Adapter Tee Valve $41.20 $0.00 ILQ Bitrac Full Face Mask $29.00 $0.00 ET Tube St tette 1 $0.00 Wi es Disenfect $11.521 $0.00 Grand Total $786.79 Approved by date