HomeMy WebLinkAbout184943 04/27/2010 CITY OF CARMEL, INDIANA VENDOR: 360209 Page 1 of 1
ONE CIVIC SQUARE ST VINCENT HOSPITAL CHECK AMOUNT: $693.62
CARMEL, INDIANA 46032 ATTN: MARILYN WHEELER, ACCT REPTNG
10330 N MERIDIAN ST SUITE 340 CHECK NUMBER: 184943
INDIANAPOLIS IN 46290
CHECK DATE: 4/27/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
102 4239011 11651 693.62 SPECIAL DEPT SUPPLIES
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 4/20/2010 11651
BILL TO
Carmel Fire EMS
Attn: Accounts Payable
2 Carmel Civic Square
Carmel, IN 46032
TERMS
Due on receipt
DESCRIPTION AMOUNT
EMS Supplies purchased March 2010 billed in April 2010 693.62
Medical Supplies: $185.60
Transfer Drugs: 508.02
TOTAL: $693.62
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 $693.62
are paying on cheek/stub. Thank you!!
Inquiries: Marilyn Wheeler Payments /Credits $0.00
Phone: 317- -583 -3297
Fax: 317 -583 -3285 Balance Due $693.62
IC130 Usage Report Run at: 4/6r2010 11:10 am
Fiscal Year 2010 Period 9 March
Company: 1 St. Vincent Indianapolis (cont.)
Accounting Unit: 8213 C armel Fire Departmen $185.60 9
Month Year -To -Date
Item Item Description Unit Qty Avg Cost Amount Qty Avg Cost Amount
Account 7315 0000 Medical Supplies $185.60 $1,403.23
101743 DRESSING GAUZE 4X4 12 PLY TRAY TY 200 $0.55 S110.00 200.00 0.55 $110.00
107905 TUBING IV EXT STD BORE 32 INCH 2 MICROCLAVE NON EA 0 $0.00 $0.00 200.00 2,50 $500.00
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 0 $0.00 $0.00 72.00 0.53 $38.16
159 TAPE SILK DURAPORE 2 INCH EA 72 $1.05 $75.60 264.00 1.05 $277.20
86934 BANDAID WOVEN 1X3 INCH EA 0 $0.00 $0.00 1,250.00 0.03 $37.50
87228 DRESSING GAUZE 4 INCH 4 YARD ROLL DERMACEA 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 $361.20
21685 MASK OXYGEN 3 IN 1 ADULT EA 0 $0.00 $0.00 300.00 0.86 $258.00
76139 BAG RESUS ADULT EA 0 $0.00 $0.00 12.00 8.60 $103.20
Account: 7570 0000 IV Irrigation Solutions $0.00 $249.48
445 SOL IV NS .9% 500ML EA 0 $0.00 $0.00 216.00 0.76 $164.16
446 SOL IV NS .9% 1000ML EA 0 $0.00 $0.00 108.00 0.79 $85.32
Page 645 of 1182
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Account Name Generic Name Trade Name Size Qty Tot Cost
02 -8213 Carmel Fire Department ADENOSINE INJ 6 MG ADENOSINE INJ 6 MG 2 ML 5 22.05
02 -8213 Carmel Fire Department Albuterol SULF NEB SOL 0.083% ALBUTEROL SULFATE 0.083% NEB SOL 0.083% 3 ML 26 4.16
02 -8213 Carmel Fire Department Albuterol SULF NEB SOL 0.083% ALBUTEROL SULFATE NEB SOL 0.083% 3 ML 114 1.68
02 -8213 Carmel Fire Department AMIODARONE HCL INJ 50 MG1mL AMIODARONE HYDROCHLORIDE INJ 50 MG/mL 3 ML 10 9.00
02 -8213 Carmel Fire Department Aspirin Tab Chew 81 MG ASPIRIN Tab Chew 81 MG 750 EA 72 1.44
02 -8213 Carmel Fire Department Atropine Sulfate INJ -SYRNG 1 MG/ 10 mL ATROPINE SULFATE INJ -SYR 1 MG/ 10 mL 110ML 1 14 41.86
02 -8213 Carmel Fire Department Dextrose INJ -SYRNG 50% DEXTROSE INJ -SYRNG 50% 1 50 mL 2 7.68
02 -8213 Carmel Fire Department DiphenhydrAMINE INJ 50 MG/mL DiphenhydrAMINE INJ 50 MG/mL 11 ML 5 3.15
02 -8213 Carmel Fire Department EpiNEPHrine HCL INJ 0.1 MGIML EPINEPHRINE HCL INJ 0.1 MG/ML 1 10 ML 1 15 26.25
02 -8213 Carmel Fire Department Glucagon INJ 1 MG GLUCAGEN DIAG. KIT INJ 1 MG 1 EA 31 199.92
02 -8213 Carmel Fire Department GLUCOSE BLOOD TEST STRIPS Test ACCU -CHEK COMFORT CURVE Test F50 EA 4 75.40
02 -8213 Carmel Fire Department Ldocaine HCL INJ -SYRNG 100 MG LIDOCAINE HCL INJ -SYRNG 100 MG 15 ML 21 5.60
02 -8213 Carmel Fire Department Magnesium SULF INJ 500 MG/mL MAGNESIUM SULFATE INJ 500 MG/mL 1 10 ML 20 57.00
02 -8213 Carmel Fire Department Nitroglycerin Tab 0.4 MG NITROQUICK Tab 0,4 MG 1 100 EA 8 13.68
02 -8213 Carmel Fire Department Ondansetron INJ 2 mg /mL ONDANSETRON INJ 2 mg/mL 12 ML 9I 4.50
02 -8213 Carmel Fire Department Ondansetron Tab ODT 4 MG ONDANSETRON Tab ODT 4 MG 1 30 EA 9 9.72
02 -8213 Carmel Fire Department Sodium Bicarbonate INJ 4.2% SODIUM BICARBONATE INJ 4.2% 110 ML 3 6.60
02 -8213 Carmel Fire Department Sodium Bicarbonate INJ 7,5% SODIUM BICARBONATE INJ 7.5% 150 ML 4 10.76
02 -8213 Carmel Fire Department SODium CHLORide INJ 0.9% 100 mL SODium CHLORide 0.9% INJ 0.9% 1000 mL 1000 ML 3 2.37
02 -8213 Carmel Fire Department SODium CHLORide INJ 0.9% 50 mL SODium CHLORide 0.9% INJ 0.9% 50 mL 50 ML 3I 4.44
02 -8213 Carmel Fire Department SODium CHLORide INJ 0.9% 500 mL SODium CHLORide 0.9% INJ 0.9% 500 mL 500 ML 1 l 0.76
r,9 L 508.02
I
VOUCHER NO. WARRANT NO.
ALLOWED 20
St. Hospital
Attn: Marilyn Wheeler, Acct. Reporting
IN SUM OF
10330 N. Meridian Street, Ste. 340
Indianapolis, IN 46290
$693.62
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# I Dept. INVOICE NO. ACCT #ITITLE AMOUNT
Board Members
1120 11651 102- 390.11 $693.62 1 hereby certify that the attached invoice(s), or
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
APR 2 6 2010
f Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed by Slate 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))
11651 $693.62
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