163411 09/03/2008 CITY OF CARMEL, INDIANA VENDOR: 360209 Page 1 of 1
tl ONE CIVIC SQUARE ST VINCENT HOSPITAL CHECK AMOUNT: $1,177.00
•i a'
CARMEL, INDIANA 46032 ATTN- MW SUITE 430 ACCT RPT
10330 N MERIDIAN ST CHECK NUMBER: 163411
INDIANAPOLIS IN 46290
CHECK DATE: 91312008
DEPARTMENT ACCOUNT PO NUMBER I NVOICE NUMBER AMOUNT DESCRIPTION
102 4239011 10215 1,177.00 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, 46290 -1024 8/20/2008 10215
BILL TO
Carmel Fire EMS
Attn: Accounts Payable
2 Carmel Civic Square
Carmel, IN 46032
TERMS
Due on receipt
DESCRIPTION AMOUNT
EMS Supplies purchased July 2008 billed in August 2008 1,177.00
Medical Supplies: 899
Respiratory Supplies: 172
Transfer Drugs: 70
1V Irrigation Solutions: 36
Total: 1,177
Any questions regarding the above charges can be directed to:
Pete Dillman, Program Director Emergency Medical Services
Phone: 317 338 -7272
'18766 1464:00. Please return one copy of invoice with payment. Total
Thanks! $1,177.00
Inquiries: Marilyn Wheeler
Phone: 317 -583 -3297
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))
10215 EMS Supplies $1,177.00
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. WAR NO.
St Vincent Hospital ALLOWED 20
Attn: Marilyn Wheeler, Acct. Reporting IN SUM OF
10330 N. Meridian Street, Ste. 340
Indianapolis, IN 46290
$1,177.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO Dept. INVOICE NO. ACCT# /TITLE AMOUNT Board Members
1120 10215 102 390.11 $1,177.00 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
AUG 2 9 2008
Title
Cast distribution ledger classification if
claim paid motor vehicle highway fund