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Home My WebLink About320537 01/11/18 CITY OF CARMEL, INDIANA VENDOR: 360209 CHECK AMOUNT: $*****1,110.19* �i ONE CIVIC SQUARE ST VINCENT HOSPITAL CARMEL, INDIANA 46032 ATTN:KRISTINE BROWN,ACCT.RPTNG CHECK NUMBER: 320537 10330 N MERIDIAN ST SUITE 430 CHECK DATE: 01/11/18 INDIANAPOLIS IN 46290 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 102 4239011 14040 1,110.19 SPECIAL DEPT SUPPLIES VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) ALLOWED 20 ACCOUNTS PAYABLE VOUCHER Vendor# 360209 IN SUM OF$ CITY OF CARMEL ST VINCENT HOSPITAL 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 $1,110.19 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 14040 42-390.11 $1,110.19 1 hereby certify that the attached invoice(s),or 12/30/17 14040 $1,110.19 1120 102 Prior Year 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,January 05,2018 David Haboush Fire Chief 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: Kristine Brown,Accg Rptg DATE INVOICE# 10330 N.Meridian Street, Suite 430 North Indianapolis,IN 46290-1024 12/30/2017 14040 BILL TO Carmel Fire EMS Attn: Denise Snyder 2 Carmel Civic Square Carmel, IN 46032 TERMS Due on receipt DESCRIPTION AMOUNT EMS Supplies purchased November 2017 0.00 .Medical Supplies November 111.76 Drugs Transferred September.-November-the pharmacy system.used to track 998:43 transfers was manual. 46029-160085-65100. Please note invoice number Total $19110.19 that you are paying on check/stub. Thank you! Inquiries: Kristine Brown Payments/Credits $0.00 Kristine.Brown@ascension.org Balance Due $19110.19 A4, Carmel Fire Department Pharm-acv Order Form 70 q vZy Outdate Month:November Date Submitted.-90-30-2097 ' DrugName nng3Qe - . eh M M M Re V C14 M w. v Total Notes v p et s Filled ti�, V O O Acetaminophen 325,thgeP"O ****Individual Ta6lets'count*�"* r ered 2 7. 9.✓.. Adenosine 6r6g Vial 0 Albuterol 2.5mg/3ml.ud 0, Amiodarone 150mg 0 ASA, -:. 81 mg Battle `,. . . Atropine 1 mg bj 3 6 6 6 5 2 _ 0 �( - 7� 60 . yO -1 Z , Atrovent 11.,ipatropium ' 0.5rh . Calcium Chloride. .1g bj 0 _ anokit_.,. 5g Kit 2 ✓ g- 1 1 �7� 136W . 50ml 0 Dextrose 25% 10m1 bj 0 Dextrose 50% 25g 0 v� Diphenhydramine 50mg 0, Epinephrine 1:1,000 30mg multi Epinephrine'_1:10,000' 1 mg bj Glucagon 1mg Val 2 1 2 : 1 6 ,/, Giucose;:Oral . tubes Levophed 4.mg/4ml Vial 0 Z. i Lidocaine Bolus I00mg b' 0 Lidocaine Jelly Tube 0 Ma Sulfate. 5nig viaVbj ,Z?� VIAL 4 1 2 7„ Na Bicarb 44.6 mEq bj 0 Naloxone-(Narcan) 2rrig bj 3. 2 Nitro Tab Normal saline 0.9% 50m1 0 Normal saline 0.9% 500ml 0 Normal wdine'0.9% 1000m1 0 0dansetron-(Z6fran) 4mg vial 0 Odansetron4Zofran ODT 4mg 2 PredniSONE 20mg Tablet 0 Racemic Epi". , .. 1.1.25mg/.5mL ud2 3 4 2 2. 13 f Solu-Medrol 125mg vial 0 Toradol=(.Ketorolac F;Omg V' 1 STATION TOTAL: 22 .11 4 18 14 Z 5 1 .5 087 0 ,� Depatmental Transfer of Supplies date submissed Requesting Department: Carmel Fire Dept Supplying Department ER Jul-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 18 $1.50 $0.00 Angiocath 20 $1.50 $0.00 Angiocath 20q 1.88 per box $95.00 $0.00 Angiocath 22 $1.50 $0.00 Angiocath 24 $1.55 $0.00 Bandaids Basin kidney shaped $0.08 $0.00 Basin round $0.31 $0.00 Ca no-Line Sampling ETCO2 Smart Ped per bx $253.00 $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 T 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) $11.52 $0.00 EZ-10 Adult Needles $495.00/box of 5 $99.00 $0.00 EZ-10 Power Driver - $295.00 $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 $1.24 $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-Marge $10.35 $0.00 IV Adapter, Luerlock 0.151 0.00 IV Dial a flow $3.15 $0.00 IV Extension 19" $1.91 $0.00 IV Lock with Ext $1.87 $0.00 IV Start Kits ea $2.88 $0.00 IV Start Kits Sobraview 100/bx $2.66 $0.00 IV Tubing 10 tt $1.16 $0.00 IV Tubbing 10 tt per case of 48 2 $55.88 $111.76 Kleenex $0.19 $0.00 KY pkt $0.10 $0.00 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 $5.18 $0.00 Pulse Ox, Peds $5.17 $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&to $3.26 $0.00 Suture Kit 1 $1.09 $0.00 SYR Hypo w/needle $0.25 $0.00 Syringe w/Needle 1 ml $0.07 $0.00 Syringe w/Needle 3 ml $0.05 $0.00 S rin a w/Needle 3 ml per case $35.76 $0.00 Syringe w/Needle 5ml $0.10 $0.00 Syringe w/Needle 5ml.1 case $69.30 $0.00 Syringe w/Needle 10 ml $0.12 $0.00 Syringe 20ml $0.16 $0.00 CFD Supply Forms FY 18 Nov'17 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 $9.63 $0.00 Tape 2" 6 rolls/box $1.00 $0.00 Tape 1" $0.50 $0.00 Tape 2"cloth adh $1.29 $0.00 Tape Trans ore 1/2" $1.28 TB ET Cuffed Rediture $1.80 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 $86.38 $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 11 Ez $443.95 $0.00 CPAP mask-1 case/10 $480.00 $0.00 CPAP Adapter Tee Valve $41.20 $0.00 Lg Bitrac Full Face Mask $29.001 0.00 ET Tube Stylette 1 $0.00 Wipes Disenfect 1 $11.521 $0.00 Grand Total $111.76 O Approved by date CFD Supply Forms FY 18 Nov'17