157253 03/05/2008 CITY OF CARMEL, INDIANA VENDOR: 360209 Page 1 of 1
0 ONE CIVIC SQUARE ST VINCENT HOSPITAL
CARMEL, INDIANA 46032 ATTN: MW SUITE 430 ACCT RPT CHECK AMOUNT: $859.00
10330 N MERIDIAN ST CHECK NUMBER: 157253
INDIANAPOLIS IN 46290
CHECK DATE: 3/5/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
102 4239011 9810 859.00 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 2/18/2008 9810
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 2008 billed in February 2008 859.00
Medical Supplies: 434
Respiratory Supplies: 144
Transfer Drugs: 281
Any questions regarding the above charges can be directed to:
Pete Dillman, Program Director Emergency Medical Services
Phone: 31.7- 338 -7272
18766- 1464.00. Please return one copy of invoice with payment.
Thanks! Total-
$859.00
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))
02/18/08 9810 EMS Supplies January $859.00
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
Sr. Vincent Hospital
IN SUM OF
Attn: Marilyn Wheeler, Acct. Reporting
10330 N. Meridian Street, Ste. 340
Indianapolis, IN 46290
$859.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept.# INVOICE NO. ACCT #/TITLE AMOUNT
Board Members
9810 102- 390.11 $859.00 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
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund