HomeMy WebLinkAbout333525 12/14/18 CITY OF CARMEL, INDIANA VENDOR: 368321
® �• ONE CIVIC SQUARE INDIANAPOLIS EMS CHECK AMOUNT: $*****5,529.34*
CARMEL, INDIANA 46032 PO
D ANAPOLIS N 46250 CHECK DATE: : 333525
E: 12/14/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4239010 101877 M82417 5,529.34 TRAUMA KIT MED SUPPLI
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
Vendor# 368321 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
INDIANAPOLIS EMS IN SUM OF$ CITY OF CARMEL
\ �X 5 03 O Z j: 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
Payee
$5,529.34
ON ACCOUNT OF APPROPRIATION FOR Purchase Order#
Carmel Police 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
101877 M82417 42-390.10 $5,529.34 1 hereby certify that the attached invoice(s),or 12/11/18 M82417 Medical supplies for trauma kit $5,529.34
1110 101 1110 101
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
Wednesday, December 12,2018
Jim Barlow
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
Indianapolis EMS Invoice
PO Box 503024
Indianapolis, IN 46250
Invoice#: M82417
Invoice Date: 12/11/2018
Due Date: 12/11/2018
Bill To: Project:
Carmel Police Dept
P.O. Number: 101877
Patricia Young
3 Civic Square
Carmel IN 46032
Date Description Amount
10/11/2018 Supplies See Itemization Attached 5,529.34
Please reference check to Invoice 29CPD EXT-4338-650069
Please remit to:IEMS PO Box 503024 Indianapolis IN 46250 Questions? Total $5,529.34
contact 317-775-6751
Payments/Credits $0.00
Balance Due $5,529.34
Invoice
SO-
' Indianapolis EMS
INDIA AP 3L�S
Eskenazi Health/Indianapolis EMS Reference# EXT-4338
E-M ,
PO Box 503024 Indianapolis,IN 46250 Date 10/11/2018
Tel 317-630-8301
wip
i4.
Billing Address 29 CPD Carmel Police Department Shipping 29 CPD Carmel Police Department
Address
Contact Megan Souttz
Item Description - Quantity Unit Price Sub-Total
0130-00000009-001 Shears,Trauma/Utility (EA) 121 EA $1.22 $147.62
0170-00000007-001 Bandage/Dressing,Gauze Roll 130 EA $0.85 $110.50
Bandage/Dressing 4 Kerlix(RL)
0170-00000025-001 Dressing,Israeli Bandage 125 EA $6.75 $843.75
0170-00000048-001 Tape 1,Silk (RL) 121 EA $0.57 $68.97
0170-00000055-001 Tourniquet,for Trauma C.A.T. 121 EA $26.00 $3,146.00
ORANGE (EA)
0170-00000058-001 Hyfin Vent Chest Seal 125 EA $7.00 $875.00
0020-00000003-002 Airway, Nasal Pharyngeal 7.0 mm 28 125 EA $2.70 $337.50
Fr (EA)
Remarks PO 101877 Sub-Total $5,529.34
Please reference check to Invoice
29CPDDEXT-4338�65Q 60 9 Total $5,529.34
Page 1 of 1