HomeMy WebLinkAbout199688 07/20/2011 a CITY OF CARMEL, INDIANA VENDOR: 360209 Page 1 of 1
ONE CIVIC SQUARE ST VINCENT HOSPITAL
i CHECK AMOUNT: $882.55
CARMEL, INDIANA 46032 ATTN: MARILYN WHEELER, ACCT REPTNG
10330 N MERIDIAN ST SUITE 340 CHECK NUMBER: 199688
INDIANAPOLIS IN 46290
CHECK DATE: 772012011
DEPARTMENT ACCOUNT PO NU MBER INVOICE NUMBER AMOUNT DESCRIPTION
102 4239011 12531 882.55 SPECIAL DEPT SUPPLIES
St. Vincent Hospital Healthcare Center, Inc. Invoice
Attn: Jeremy Zimmerman, Acct Reporting
10330 N. Meridian St., Suite 430 North DATE INVOICE
Indianapolis, IN 46290 -1024 St.Vincent
5/1/2011 12531
BILL TO
Carmel Fire EMS
Attn: Accounts Payable
2 Carmel Civic Square
Carmel, IN 46032
TERMS
Due on receipt
DESCRIPTION AMOUNT
EMS Supplies purchased April 2011 billed in May 2011 882.55
Medical Supplies: $882.55
Transfer Drugs:
TOTAL:, $882.55
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 thatyou Total $882.55
are paying on check/stub. Thank you!!
Inquiries: Jeremy Zimmerman payments /Credits $0.00
317.583.3223
jrzimmer @stvincent.org Balance Due $882.55
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Control Controll Control Contro12 TotalPic TotalPicl
02 -8213 Carmel Fire Department ADENOSINE INJ 6 MG ADENOSINE INJ 6 MG 2 ML 3 $8.67
02 -8213 Carmel Fire Department Albuterol SULF NEB SOL (0.083 ALBUTEROL SULFATE 0.083% NEB SOL (0.033 3 ML 121 $19.36
02 -8213 Carmel Fire Department AMIODARONE HCL INJ 50 MG/mL AMIODARONE HYDROCHLORIDE INJ 50 MG mL 3 ML 7 $5.53
02 -8213 Carmel Fire Department Aspirin Tab Chew 81 MG ASPIRIN Tab Chew 81 MG 750 EA 36 $0.72
02 -8213 Carmel Fire Department Atropine Sulfate INJ -SYRNG 1 MG/ 10 mL ATROPINE SULFATE INJ -SYR 1 MG/ 10 mL 10 ML 14 $100.24
02 -8213 Carmel Fire Department Dextrose DOParv6e INJ 400 MG 1250 mL DEXTROSEIDOPamine HCL [NJ 400 MG 1250 mL 250 ML 3 $19.08
02 -8213 Carmel Fire Department Dextrose INJ -SYRNG 50% DEXTROSE INJ SYRNG 50% 50 mL 12 $46.08
02 -8213 Carmel Fire Department EpiNEPHrine HCLIINJ 0.1 MG/mL EPINEPHRINE HCL 3 -112in INJ 0.1 MG/mL 10 ML 8 $27.28
02 -8213 Carmel Fire Department EpiNEPHrine HCL -INJ 0.1 MG/ML EPINEPHRINE HCL INJ 0.1 MG/ML 10 ML 11 $45.98
02 -8213 Carmel Fire Department Glucagon INJ 1 MG;- GLUCAGEN DIAG. KIT INJ 1 MG 1 EA 2 $151.42
02 -8213 Carmel Fire Department Glucose (Dextrose) GEL 40% GLUTOSE 15 GEL 40% 15 GM 6 $15.18
02 -8213 Carmel Fire Department GLUCOSE BLOOD TEST STRIPS Test ACCU -CHEK COMFORT CURVE Test 50 EA 6 $113.10
02 -8213 Carmel Fire Department Lancet DEV i ACCU -CHEK SAFE -T -PRO PLUS DEV 200 EA 3 $96.00
02 -8213 Carmel Fire Department Lidocaine HCL INJ -SYRNG 100 MG LIDOCAINE HCL INJ -SYRNG 100 MG 5 ML 5 $14.00
02 -8213 Carmel Fire Department Lidocaine HCL JELLY 2% 30 GM LIDOCAINE HCL JELLY 2% 30 GM 30 ML 1 $6.10
02 -8213 Carmel Fire Department Magnesium SULFIINJ 500 MG/ml- MAGNESIUM SULFATE INJ 500 MG/mL 10 ML 3 $8.55
02 -8213 Carmel Fire Department Naloxone INJ 1 MG/Ml- NALOXONE HCL INJ 1 MG/Ml- 2 ML 4 $49.08
02 -8213 Carmel Fire Department Ondansetron INJ 2 mg1mL ONDANSETRON INJ 2 mg/mL 2 ML 11 $3.41
02 -8213 Carmel Fire Department Ondansetron Tab PDT 4 MG ONDANSETRON Tab ODT 4 MG 30 EA 8 $8.64
02 -8213 Carmel Fire Department Sodium Bicarbonate INJ 7.5% SODIUM BICARBONATE. INJ 7.5% 50 ML 20 $128.40
02 -8213 Carmel Fire Department SODium CHLORide INJ 0.9% 1000 mL SODium CHLORide 0.9% INJ 0.9% 1000 mL 1000 ML 13 $10.27
02 -8213 Carmel Fire Department SODium CHLORide INJ 0.9% 50 mL SODium CHLORide 0.9% INJ 0.9% 50 mL 50 ML 1 $0.90
02 -8213 Carmel Fire Department SODium CHLORide INJ 0.9% 500 mL SODium CHLORide 0.9% INJ 0.9% 500 mL 500 ML 6 $4.56
304 $882.55
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Prescribed by Slate Board of Accounts City Form No. 201 (Rev. 1955)
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
whore, 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))
12531 $882.55
1 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 NO.
ALLOWED 20
St. Vincent Hospital
Attn: Marilyn Wheeler, Acct. Reporting
IN SUM OF
10330 N. Meridian Street, Ste. 340
Indianapolis, IN 46290
$882.55
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. I ACCT /TITLE I AMOUNT Board Members
1120 I 12531 1 102- 390.11 I $882.55 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
jUL 18 2019
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund