HomeMy WebLinkAbout155519 01/10/2008 CITY OF CARMEL, INDIANA VENDOR: 360209 Page 1 of 1
ONE CIVIC SQUARE ST VINCENT HOSPITAL
CHECK AMOUNT: $729.40
CARMEL INDIANA 46032 ATTN: MW SUITE 430 ACCT RPT
ST MERID
N
10330 IAN
«a CHECK NUMBER: 155519,
INDIANAPOLIS IN 46290
CHECK DATE: 111012408
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
X02 4239011 9677 729.00 SPECIAL DEPT SUPPLIES
F
St. Vincent Hospital Healthcare Center, Inc. Invoice
Attn: Marilyn Wheeler, Acct Reporting
10330 N. Meridian St., Suite 430 DATE INVOICE
Indianapolis, 46290 12/21/2007 9677
BILL TO
Carmel Fire EMS
Attn: Accounts Payable
2 Carmel Civic Square
Carmel, IN 46032
TERMS
Due on receipt
DESCRIPTION AMOUNT
EMS Supplies purchased November 2007 billed in December 2007 729.00
Medical Supplies: 16.00
Anesthesia: 111.00
Transfer Drugs: 602.00
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! $729.00
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))
.v
p .v
h
A
Total
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
IN SUM OF
ON ACCOUNT OF APPROPRIATION FOR
Board Members
Po# or INVOICE NO. ACCT #!TITLE AMOUNT
DEFT. I 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
t
r
Signature
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund