HomeMy WebLinkAbout319198 11/30/17 i
ti• CITY OF CARMEL, INDIANA VENDOR: 360209
ONE CIVIC SQUARE ST VINCENT HOSPITAL CHECK AMOUNT: $*******389 17*
?Q CARMEL, INDIANA 46032 ATTN:KRISTINE BROWN,ACCT.RPTNG CHECK NUMBER: 319198
9 [TON gip" 10330 N MERIDIAN ST SUITE 430 CHECK DATE: 11/30/17
INDIANAPOLIS IN 46290
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
102 4239011 14023 389.17 SPECIAL DEPT SUPPLIES
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
Vendor# 360209 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
ST VINCENT HOSPITAL IN SUM OF$ CITY OF CARMEL
ATTN: KRISTINE BROWN,ACCT. RPTNG An invoice or bill to be properly itemized must show:kind of service,where performed,dates service
10330 N MERIDIAN ST SUITE 430 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
INDIANAPOLIS, IN 46290
Payee
$389.17
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
14023 42-390.11 $389.17 1 hereby certify that the attached invoice(s),or 11/28/17 14023 $389.17
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, November 28,2017
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
20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer
St. Vincent Hosp &Healthcare Center, Inca Invoice
Attn: Kristine Brown,Acct Rptg
10330 N. Meridian St., Suite 430 North DATE INVOICE#
Indianapolis, IN 46290-1024 11/17/2017 14023
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 2017 0.00
Medical Supplies October 389.17
Drugs Transferred October-the pharmacy system used to track transfers is
down. September, October&November will be billed in December.
46029-160085-65100. Please note invoice number Total $389.17
that you are paying on check/stub. Thank you!
Inquiries: Kristine Brown Payments/Credits $0.00
Kristine.Brown@ascension.org Balance Due $389.17