160083 05/28/2008 3
CITY OF CARMEL, INDIANA VENDOR; 360209 Page 1 of 1
ONE CIVIC SQUARE ST VINCENT HOSPITAL
o CARMEL, INDIANA 46032 ATTN: MW SUITE 430 ACCT RPT CHECK AMOUNT: $945.00
L 10330 N MERIDIAN ST CHECK NUMBER: 160083
INDIANAPOLIS IN 46290
CHECK DATE: 5/2812008
DEPARTMENT A CCOUNT PO NUMBE INVO NU MBER AMOUNT DESC
:102 4239011 10009 945.00 SPECIAL DEPT SUPPLIES
F
St. Vincent Hospital Healthcare Center, Inc. Invoice
Attn: Marilyn Wheeler, Acct Reporting
1.0330 N. Meridian St., Suite 430 North DATE INVOICE
Indianapolis, 46290 -1024 5/15/2008 10009
BILL TO
Carmel Fire EMS
Attn: Accounts Payable
2 Carmel Civic Square
Carmel, IN 46032
Due on receipt
DESCRIPTION AMOUNT
EMS Supplies purchased April 2008 billed in May 2008 945.00
Medical Supplies: $103
Respiratory Supplies: $275
Transfer Drugs: $502
N Irrigation Solutions: $55
Transfer Dietary: $10
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! $945.00
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))
05/15/08 10009 EMS Supplies $945.00
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.. WARRANT NO.
ALLOWED 20
-5t. Vincent Hospital
Attn: Marilyn Wheeler, Acct. Reporting IN SUM OF
10330 N. Meridian Street, Ste. 340
Indianapolis, IN 46290
$945.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# 1 Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
1120 10009 102 390.11 $945.00 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
4
r 17
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund