The URL can be used to link to this page

Home My WebLink About183007 03/03/2010 CITY OF CARMEL, INDIANA VENDOR: 360209 Page 1 of 1 ONE CIVIC SQUARE ST VINCENT HOSPITAL CARMEL, INDIANA 46032 ATTN: MARILYN WHEELER, ACCT REPTNG CHECK AMOUNT: $2,480.36 10330 N MERIDIAN ST SUITE 340 CHECK NUMBER: 183007 INDIANAPOLIS IN 46290 CHECK DATE: 3/3/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 102 4239011 11550 1,614.11 SPECIAL DEPT SUPPLIES 1120 4357001 11554 866.25 INTERNAL TRAINING FEE St. Vincent Hospital Healthcare Center, Inc. Invoice Attn: Marilyn Wheeler, Acct Reporting 10330 N. Meridian St., Suite 430 North DATE INVOICE Indianapolis, IN 46290 -1024 2/16/2010 11550 BILL TO Carmel Fire EMS Attn: Accounts Payable 2 Carmel Civic Square Carmel, IN 46032 TERMS Due on receipt DESCRIPTION AMOUNT EMS Supplies purchased January 2010 billed in February 2010 1,614.11 Medical Supplies: $755.45 Medical Supplies: 679.68 Transfer Drugs: 178.98 TOTAL: $1,614.11 See Attached Any questions regarding the above charges can be directed to: Pete Dillman, Program Director Emergency Medical Services Phone: 317 -338 -7272 1 -8766 -1464. Please notate invoice number that you Total $1,614,11 are paying on checklstub. Thank you!! Inquiries: Marilyn Wheeler Payments /Credits $0.00 Phone: 317 -583 -3297 Fax: 317 -583 -3285 Balance Due $19614.11 Depatmental Transfer of Supplies date Oct Nov Dec Requesting'Department: Carmel Fire Dept Supplying Department ER Cost Center 8213 Cost Center 27230 ITEM QUANTITY UNIT COST TOTAL COST Alcohol preps 9219 2 $2.67 $5.34 Angiocath 18g 1266 15 $1.50 $22.50 Angiocath 20g 1264 15 $1.50 $22.50 Angiocath 22g 1262 10 1 $1.50 $15.00 Angiocath 24g 1261 10 $1.55 $15.50 Basin kidney shaped 10302 $0.08 $0.00 Basin round 10297 18 $0.31 $5.58 Coban 24 $0.56 $0.00 Cold paks 45779 $0.57 $0.00 EKG Electrodes 72104 23 $3.12 $71.76 EZ -10 Adult Needles ($495.00 /box of 5) $99.00 $0.00 Foam Quikcare 5033 $2.67 $0.00 Guaze, 2 x 2 Cotton bail 9170 2 $1.88 $3.76 Guaze, 2 X 2 Sterile 9242 2 $0.02 $0.04 Gauze 4 X 3 spong (per box) 9173 $1.24 $0..00. Gauze 4 x 4 tub 10673 $0.32 $0.00 Gauze Kerlex 9217 4 $0.67 $2.68 Gloves Med 985 1 $5.41 $5.41 Gloves Large 986 2 $5.41 $10.82 Gloves Xiarge 34059 $5.95 $0.00 IV Adapter, Luerlock 1260 20 $0.15 $3.00 IV Dial a flow 17477 $3.15 $0.00 IV Extension 19" 1223 7 $1.91 $13.37 IV Lock with Ext 1221 21 $1.87 $39.27 IV Start Kits (100 /bx) 78663 26 $1.00 $26.00 IV Tubing 15gtt 486 20 $1.17 $23.40 KY pkt 12186 $0.10 $0.00 Razor, disposeable 910 $0.12 $0.00 Sharps Container 23636 1 $4.59 $4.59 Sterile H2O bottle 384 3 $0.71 $2.13 Suction Canister top 3634 1 $3.26 $3.26 Syringe w /Needle 1 ml 2028 13 $0.07 $0.91 Syringe w /Needle 3 mf 2014 36 $0.05 $1.80 Syringe w /Needle 5ml 2030 $0.10 $0.00 Syringe w /Needle 10 ml 2031 $0.12 $0.00 Syringe w Saline 3ml 105371 10 $0.28 $2.80 Syringe wlSaline10ml 37350 90 $0.32 $28.80 30 ml saline vials (per box) 330 1 $9.63 $9.63 Tape 2" (6 rolls /box) 159 7 $1.00 $7.00 Tape 1" 158 $0.50 $0.00 Tape 2" cloth adh 181 3 $1.29 $3.87 Tape Transpore 1/2" 143 6 $0.34 $2.04 Tegaderm 208 1 $0.24 $0.24 Tourniguets (50 /pkg) 10457 1 $0.11 $0.11 Warm paks 3416 $1.46 $0.00 Wou Clea nser 17344 $5.04 $0.00 Suction Canister top 3634 $3.26 $0.00 Yankauers 9377 1 $0.34 $0.34 Ambu Bag w /mask -Adult 18696 5 $8.60 $43.00 Ambu Bag wlmask Peds 37012 1 $15.00 $15.00 Ambu Bag wlmask Infant cs /10 15071 1 $16.00 $16.00 ill CPAP mask 6 $50.00 $300.00 ET Tube Stylette 71671 1 $28.00 $28.00r Wipes Disenfect 190 $11.52 $0.00 Grand Total $755.45 4pproved by 7 date �68 /Q Account Name Generic Name Trade Name Size Qty I Tot Cost 02 -8213 Carmel Fire Department ADENOSINE INJ 6 M ADENOSINE INJ 6 MG 2 ML 31 13.23 02 -8213 Carmel Fire Department lAlbuterol SULF NEB SOL 0.083% JALBUTEROL SULFATE NEB SOL 0.083% 3 ML 1 351 4.20 02 -8213 Carmel Fire Department JAMIODARONE HCL INJ 50 MG/mL AMIODAR HYDROCHLORIDE INJ 50 MG/mL 3 ML 9 8.10 02 -8213 Carmel Fire Department [Aspirin Tab Chew 81 MG ASPIRIN Tab Chew 81 MG 750 EA 108 2.16 02 -8213 Carmel Fire Department Atropine Sulfate INJ -SYRNG 1 MG/ 10 mL (ATROPINE SULFATE INJ -SYR 1 MG/ 10 mL 1 10 ML 1 12 33.72 02 -8213 Carmel Fire Department CALcium CHLORide INJ -SYRNG 100 MG/mL ICALcium CHLORide INJ -SYRNG 100 MGFmL 110 ML I 1 2.69 02 -8213 Carmel Fire Department Dextrose INJ -SYRNG 5 0% iDEXTROSE INJ -SYRNG 50% X50 mL 1 3.84 02 -8213 Carmel Fire Department DiphenhydrAMINE INJ 50 MG/mL IDiphenhydrAMINE INJ 50 MGImL 1 ML 1 0.63 02 -8213 Carmel Fire Department EpiNEPHrine HCL INJ 0.1 MG/ML 1EPINEPHRINE HCL INJ 0.1 MG/ML 10 ML 23 40.25 02 -8213 Carmel Fire Department Glucagon INJ 1 MG 1GL UCAGE N DIAL, KIT INJ 1 MG 1 EA 21$ 133.28 02 -8213 Carmel Fire Department J Gucose (Dextrose) GEL 40% IGLUTOSE 15 GEL 40% 15 GM 1 21 5.06 02 -8213 Carmel Fire Department (GLUCOSE BLOOD TE=ST STRIPS Test JACCU -CHEK COMFORT CURVE Test 50 EA 71 210.58 02 -8213 Carmel Fire Department Lidocaine HCL INJ -SYRNG 100 MG LIDOCAINE HCL lNJ -SYRNG 100 MG 5 ML 21 5.60 02 -8213 Carmel Fire Department Lidocaine HCL JELLY 2% 30 GM LIDOCAINE HCL JELLY 2% 30 GM 30 ML 21 15.34 02 -8213 Carmel Fire Department INaloxone INJ 1 MG/ML NA LOXONE HCL INJ 1 MG/ML 2 ML 161 184.16 02 -8213 Carmel Fire Department I Nitroglycerin Tab 0 M G NITROQUICK Tab 0.4 MG 100 EA 11 1.71 02 -8213 Carmel Fire Department Ondansetron INJ 2 mg/mL ONDANSETRON INJ 2 mg/mL 2 ML I 17 8.50 02 -8213 Carmel Fire Department Ondansetron Tab ODT 4 MG ONDANSETRON Tab ODT 4 MG 30 EA 4 4.32 02 -8213 Carmel Fire Department Sodium Chloride INJ 0.9% 1000 mL SODium CHLORide 0.9% INJ 0.9% 1000 mL 1 1000 ML 1 0.79 02 -8213 Carmel Fire Department (Sodium Chloride INJ 0.9% 500 ml_ ISODium CHLORide 0.9% INJ 0.9% 500 mL 1500 ML 2 1.52 f1 D,/O 679.68 i IC130 Usage Report Run at: 2i4/2010 7:08 am 1 k Fiscal Year 2010 Period 7 January Company: 1 St. Vincent Indianapolis (cont.) Accounting Unit: 8213 Carmel Fire Department $178.98 Month Year -To -Date Item Item Description Unit Qty Avg Cost Amount Qty Avg Cost Amount i Account: 7315 0000 Medical Supplies $151.26 $71 7.63 1223 TUBING IV EXT 1 ULTRASITE PORT 19 INCH EA 0 $0.00 $0.00 117.00 2.05 $239.85 158 TAPE SILK DURAPORE 1 INCH EA 72 $0.53 $38.16 72.00 0.53 $38.16 159 TAPE SILK DURAPORE 2 INCH EA 72 $1.05 $75.60 192.00 1.05 $201.60 86934 BANDAID WOVEN 1X3 INCH EA 1,250 $0.03 $37.50 1,250.00 0.03 $3750 87228 DRESSING GAUZE FLUFF 45X4.1 ROLL, DERMACF.,A EA 0 $0.00 $0.00 300.00 0.51 $153.00 87235 DRESSING ABD 5X9 STERILE EA 0 $0.00 $0.00 432.00 0.11 $47.52 Account: 7330 0000 Respiratory Supplies $0.00 $18920 21685 MASK OXYGEN 3 IN 1 ADULT LA 0 $0.00 $0.00 100.00 0.86 $86.00 76139 BAG RESUS ADULT EA 0 $0.00 $0.00 1200 8.60 $103.20 Account: 7570 0000 TV Irrigation Solutions $27.72 $221.76 445 SOL IV NS .9% 500ML EA 24 $0.76 $18.24 192.00 0.76 $145.92 446 SOL TV NS .9% 1000ML EA 12 $0.79 $9.48 96.00 0.79 $75.84 i Page 598 of 1068 St. Vincent Hospital Healthcare Center, Inc. Invoice Attn: Marilyn Wheeler, Acct Reporting 10330 N. Meridian St., Suite 430 North DATE INVOICE Indianapolis, IN 46290 -1024 2/18/2010 11554 BILL TO Carmel Fire EMS Attn: Accounts Payable 2 Carmel Civic Square Carmel, IN 46032 TERMS Due on receipt DESCRIPTION AMOUNT EMS 2010 Protocol Books 866.25 175 $4.95 $866.25 Any questions regarding the above charges can be directed to: Pete Dillman, Program Director Emergency Medical Services Phone: 317 338 -7272 1 -8766 -1464. Please notate invoice number that you Total $866.25 are paying on checklstub. Thank you!! Inquiries: Marilyn Wheeler Payments /Credits $0.00 Phone: 317 -583 -3297 Fax: 317 -583 -3285 Balance Due $866.25 Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995) ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL 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. Payee Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 11554 $866.25 11550 $1,614.11 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 Clerk- Treasurer VOUCHER NO. WARRANT N ALLOWED 20 St. Vincent Hospital Attn: Marilyn Wheeler, Acct. Reporting IN SUM OF 10330 N. Meridian Street, Ste. 340 Indianapolis, IN 46290 $2,480.36 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO# Dept. INVOICE NO. ACCT #!TITLE AMOUNT Board Members 1120 11554 43- 570.01 $866.25 1 hereby certify that the attached invoice(s), or 1120 11550 102- 390.11 $1,614.11 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 FEB 2 6 2010 Fire Chief Title Cost distribution ledger classification if claim paid motor vehicle highway fund