HomeMy WebLinkAbout204978 12/20/2011 CITY OF CARMEL, INDIANA VENDOR: 360209 Page 1 of 1
ONE CIVIC SQUARE ST VINCENT HOSPITAL CHECK AMOUNT: $1,506.61
CARMEL, INDIANA 46032 ATTN: J ZIMMERMAN, ACCT REPTNG
10330 N MERIDIAN ST SUITE 340 CHECK NUMBER: 204978
INDIANAPOLIS IN 46290
CHECK DATE: 12/20/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
102 4239011 12810 1,506.61 SPECIAL DEPT SUPPLIES
St. Vincent hospital healthcare Venter, Inc. Invoice
Attn: Jeremy Zimmerman, Acct Rptg
10330 N. Meridian St., Suite 430 North DATE INVOICE
Indianapolis, IN 46290 -1024 St.Vincent
12/9/2011 12810
BILL TO
Carmel Fire EMS
Attn: Accounts Payable
2 Carmel Civic Square
Carmel, IN 46032
TERMS
Due on receipt
DESCRIPTION AMOUNT
EMS Supplies purchased Nov. 2011 billed in Dec. 2011 1,506.61
Medical Supplies: $816.66
Transfer Drugs: 689.95
TOTAL: $1506.61
See Attached
Any questions regarding the above charges can be directed to:
Pete Dillman, Program Director Emergency Medical Services
Phone: 317- 338 -7272
1- 8766 -1464. Please notate invoice number that you Total $1,506.61
are paying on check/stub. Thank you!!
Inquiries: Jeremy Zimmerman payments /Credits $0.00
317.583.3223
jrzimmer @stvincent.org Balance Due $19506.61
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))
12810 $1,506.61
1 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. WARRAN NO.
ALLOWED 20
St. Vincent Hospital
Attn: Jeremy Zimmerman, Acct. Reporting
IN SUM OF
10330 N. Meridian Street, Ste. 430 N
Indianapolis, IN 46290
$1,506.61
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT #!TITLE AMOUNT Board Members
1120 I 12810 1 102- 390.11 I $1,506.61 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
DEC 19 2011
S
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund