164441 09/30/2008 CITY OF CARMEL, INDIANA VENDOR: 360209 Page 1 of 1
ONE CIVIC SQUARE ST VINCENT HOSPITAL
CARMEL, INDIANA 46032 ATfN: MW SUITE 430 ACCT RPT CHECK AMOUNT: $943.00
10330 N MERIDIAN ST CHECK NUMBER: 164441
INDIANAPOLIS IN 46290
CHECK DATE: 9/30/2008
G 7EPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
102 4239011 10275 943.00 SPECIAL DEPT SUPPLIES
mss°
St. Vincent Hospital Healthcare Center, Inc. Invoice
Attn: Marilyn Wheeler, Acct Reporting
10330 N. Meridian St., Suite 430 North DATE INVOICE
Indianapolis, 46290 -1024 9/11/2008 10275
BILL TO
Carmel Fire EMS
Attn: Accounts Payable
2 Carmel Civic Square
Carmel, IN 46032
TERMS
Due on receipt
DESCRIPTION AMOUNT
EMS Supplies purchased August 2008 billed in September 2008 943.00
Medical Supplies: 583
Respiratory Supplies: 133
Transfer Drugs: 153
IV Irrigation Solutions: 74
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! $943.00
Inquiries: Marilyn Wheeler
Phone: 31.7 -583 -3297
Prescribed by State Board of Accounts City Fofrn No. 20;t (Rev. 1995)
u.
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))
10275 EMS Supplies $943.00
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
M—IC 'IER 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
$943.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT
Board Members
1120 10275 102 390.11 $943.00 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
6
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund