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HomeMy WebLinkAbout323870 04/06/18 CITY OF CARMEL, INDIANA VENDOR: 360209 .; � �l•: ONE CIVIC SQUARE ST VINCENT HOSPITAL CHECK AMOUNT: $*****3,400.00* CARMEL, INDIANA 46032 ATTN:KRISTINE BROWN,ACCT.RPTNG CHECK NUMBER: 323870 10330 N MERIDIAN ST SUITE 430 CHECK DATE: 04/06/18 INDIANAPOLIS IN 46290 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 102 R4467006 101036 1008024 3,400.00 02 REFILL UNITS z ' VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995) ALLOWED 20 ACCOUNTS PAYABLE VOUCHER Vendor# 360209 ST VINCENT HOSPITAL IN SUM OF$ 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 $3,400.00 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 101036 1008024 44-670.06 $3,400.00 1 hereby certify that the attached invoice(s),or 3/29/18 1008024 $3,400.00 1120 Encumbered 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 Thursday, March 29,2018 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 Home Medical 2020 MERIDIAN ST. SUITE 180 ANDERSON, IN 46016-4337 Invoice (765) 646 8366 Misc Customer Print Date 3/29/2018 FIRE DEPT CARMEL First Print 2/6/2018 2 Civic Square Invoice 1008024 CARMEL,IN 46032 Order 236620 Account No. Qty Date Description Charges/Debits Payments/Credits 4 02/02/2018 , RSCO04 $2,200.00 CONC HOME FILL Bill to Cost center 8123 03/29/2018 Adjust Allowable Adjust Allowable $200.00 4 02/02/2018 RSCO26 $800.00 5L OXYGEN CONCENTRATOR Bill to Cost center 8123 12 02/02/2018 HOMEFILLDPOST $600.00 SELF FILL D CYLINDERS Bill to Cost center 8123 Total $3,600.00 $200.00 Balance $3,400.00 Payment Cash Check Charge PAY THIS AMOUNT : $3,400.00 Comments Name CC# Expires BT-INV4-79341 Page 1