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Home My WebLink About227501 12/17/2013 CITY OF CARMEL, INDIANA VENDOR: 360209 Page 1 of 1 ONE CIVIC SQUARE ST VINCENT HOSPITAL CARMEL, INDIANA 46032 ATTN.CAROLYN TERRY,ACCT REPTNG CHECK AMOUNT: $5,771.94 10330 N MERIDIAN ST SUITE 430 CHECK NUMBER: 227501 *jf jON�0. INDIANAPOLIS IN 46290 CHECK DATE: 12/17/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 102 4239011 13270 807 . 25 SPECIAL DEPT SUPPLIES 102 4239011 13271 2 , 344 . 76 SPECIAL DEPT SUPPLIES 102 4239011 13285 2 , 619 . 93 SPECIAL DEPT SUPPLIES St. Vincent Hospital &Healthcare Center, Invoice Y_ Attn: Carolyn Terry, Acct Rptg 10330 N. Meridian St., Suite 430 North DATE INVOICE# Indianapolis, IN 46290-1024 1.2/10/2013 13285 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 2013,billed December 2013 2,619.93 Medical Supplies: $652.60 Transfer- Drugs: 1,967.33 November Total: $2,619.93 1-8766-1464. Please notate invoice number thatyou Total $2,619.93 are paying on check/stub. Thank you!! Inquiries: Carolyn Terry Payments/Credits $0.00 317.583.3301 cmterry @stvincent.org Balance Due $2,619.93 Depatmental Transfer of Supplies date submissed 12/02/13 Requesting Department: Carmel Fire Dept Supplying Department ER Cost Center 8213 Cost Center 27230 ITEM# I QUANTITY UNIT COST TOTAL COST Alcohol preps 92191 $2.67 $0.00 An iocath 189 1266 $1.50 $0.00 An iocath 20g 1264 20 $1.50 $30.00 An iocath 22g 1262 $1.50 $0.00 An iocath 24g 1261 1.551 $0.00 Basin kidney shaped 10302 $0.08 $0.00 Basin round 10297 $0.31 $0.00 Cold paks 45779 $0.57 $0.00 EKG Electrodes 72104 $3.12 $0.00 Emesis Bas (per pack 118984 $11.52 $0.00 EZ-10 Adult Needles $495.00/box of 5) $99.00 $0.00 Foam -Quikcare 5033 $2.67 $0.00 Guaze, 2 x 2 Cotton bail 9170 $1.88 $0.00 Gauze Kerlex 9217 $0.67 $0.00 Gloves- Med 985 $5.41 $0.00 Gloves-Large 986 $5.41 $0.00 Gloves-Xlar a 34059 5.951 $0.00 IV Adapter, Luerlock 1260 $0.151 $0.00 IV Dial a flow 17477 $3.15 $0.00 IV Extension 19" 1223 $1.91 $0.00 IV Lock with Ext 1221 $1.87 $0.00 IV Start Kits 100/bx) 78663 $1.00 $0.00 IV Start Kits Sobraview(100/bx) 116570 $2.66 $0.00 IV Tubing 15 tt 486 $1.17 $0.00 Kerlix 4.5"x6 ply 201627 $0.73 $0.00 Microdot Xtra Test Strips 20 $24.95 $499.00 Microdot Xtra Control Solutions 10 $12.001 $120.00 Normal Saline 1000 cc bags/ca 446 $9.48 $0.00 Razor, dis oseable 910 $0.12 $0.00 Scapel#11 LUM1948 $1.30 $0,00 Sharps Container 23636 $4.59 $0.00 Sterile H2O bottle 384 $0.71 $0.00 Suction Canister&top 3634 $3.26 $0.00 Suture Kit 1 $1.09 $0.00 .Syringe w/Needle 1 ml 2028 $0.07 $0.00 Syringe w/Needle 3 ml 2014 $0.05 $0.00 Syringe w/Needle 5ml 2030 $0.10 $0.00 Syringe w/Needle 10 ml 2031 30 $0.12 $3.60 Syringe w Saline 3ml 105371 $0.28 $0.00 Syringe w/Salinel0ml 37350 $0.32 $0.00 30 ml saline vials(per box) 330 $9.63 $0.00 Tape 2" (6 rolls/box) 159 $1.00 $0.00 Tae 1" 158 0,501 $0.00 Tape 2" cloth adh 181 1.291 $0.00 Tape Transpore 1/2" $1.28 $0.00 Warm paks 3416 $1.46 $0.00 Wound Cleanser 17344 $5.04 $0.00 Suction Canister&top 3634 $3.26 $0.00 Yankauers 9377 $0.34 $0.00 Ambu Bag w/mask-Adult 18696 $8.60 $0.00 Ambu Bag w/mask- Peds 37012 $15.00 $0.00 Ambu Bag w/mask- Infant cs/10 15071 $16.00 $0.00 CPAP mask $50.00 $0.00 L9 Bitrac Full Face Mask $29.00 $0.00 ET Tube Stylette 71671 $0.00 Wi es Disenfect 21190 $11.521 $0.00 Grand Total $652.60 VOUCHER NO. WARRANT NO, ALLOWED 20 St. Vincent Hospital Attn: Carolyn Terry, Acct. Reporting IN SUM OF $ 10330 N. Meridian Street, Ste. 430 N Indianapolis, IN 46290 $2,619.93 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO#/Dept. INVOICE NO. I ACCT#/TITLE AMOUNT Board Members 1120 I 13285 1 102-390.11 I $2,619.93 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 16 2013 Fire Chief Title Cost distribution ledger classification if claim paid motor vehicle highway fund 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)) 13285 $2,619.93 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 St. Vincent Hospital & Healthcare Center, Invoice T... Attn: Carolyn Terry, Acct Rptg 10330 N. Meridian St., Suite 430 North DATE INVOICE# Indianapolis, IN 46290-1024 11/26/2013 13270 BILL TO Carmel Fire EMS Attn: Accounts Payable 2 Carmel Civic Square Carmel, IN 46032 TERMS Due on receipt DESCRIPTION AMOUNT EMS Supplies Purchased September 2013 807.25 Medical Supplies $114.33 Transfer -Drugs 692.92 TOTAL: $807.25 See attached. Total $807.25 Inquiries: Carolyn Terry Payments/Credits $0.00 317.583.3301 cmterry @stvincent.org Balance Due $807.25 Depatmental Transfer of Supplies date submissed Oct-t3 .equesting Department: Carmel Fire Dept Supplying Department ER ost Center 8213 Cost Center 27230 ITEM# QUANTITY UNIT COST TOTAL COST ,Icohol preps 9219 $2.67 $0.00 kngiocath 18g 1266 $1.50 $0.00 mgiocath 20g 1264 20 $1.50 $30.00 i kngiocath 22g 1262 $1.50 $0.00 j \ngiocath 249 1261 $1.55 $0.00 i 3asin kidney shaped 10302 $0.08 $0.00 I 3asin round 10297 $0.31 $0.00 'old paks 45779 $0.57 $0.00 EKG Electrodes 72104 $3.12 $0.00 Emesis Bags(per pack) 118984 $11.52 $0.00 EZ-10 Adult Needles $495.00/box of 5) $99.00 $0.00 Foam-Quikcare 5033 $2.67 $0.00 Guaze, 2 x 2 Cotton bail 9170 $1.88 $0.00 Gauze Kerlex 9217 $0.67 $0.00 Gloves-Med 985 $5.41 $0.00 Gloves-Lar a 986 $5.41 $0.00 Gloves-Xlar e 34059 $5.95 $0.00 IV Adapter, Luerlock 1260 $0.15 $0.00 IV Dial a flow 17477 $3.15 $0.00 IV Extension 19" 1223 $1.91 $0.00 IV Lock with Ext 1221 5 $1.87 $9.35 IV Start Kits(100/bx) 78663 $1.00 $0.00 IV Start Kits Sobraview 100/bx) 116570 28 $2.66 $74.48 IV Tubing 15 tt 486 $1.17 $0.00 Kerlix 4.5"x6pl 201627 $0.73 $0.00 Razor,dis oseable 910 $0.12 $0.00 Normal Saline 1000 cc bags/ca 446 $9.48 $0.00 Sca el#11 LUM1948 $1.30 $0.00 Sharps Container 23636 $4.59 $0.00 Sterile H2O bottle 384 $0.71 $0.00 Suction Canister&top 3634 $3.26 $0.00 Suture Kit 1 $1.09 $0.00 Syringe w/Needle 1 ml 2028 $0.07 $0.00 Syringe w/Needle 3 ml 2014 10 $0.05 $0.50 Syringe w/Needle 5ml 2030 $0.10 $0.00 S tinge w/Needle 10 ml 2031 $0.12 $0.00 Syringe w Saline 3ml 105371 $0.28 $0.00 Syringe w/Salinel0ml 37350 $0.32 $0.00 30 ml saline vials(per box) 330 $9.63 $0.00 Tape Z'_(6 rolls/box) 159 $1.00 $0.00 Tae 1" 158 $0.50 $0.00 Tape 2"cloth adh 181 $1.29 $0.00 Tape Transpore 1/2" $1.28 $0.00 Ultra Trak Ultimate Test Control $83.30 Ultra Trak Ultimate Test Strips/10 BX $330.00 $0.00 Warm paks 3416 $1:46 $0.00 Wound Cleanser 17344 $5.04 $0.00 Suction Canister&top 3634 $3.26 $0.00 Yankauers. 9377 $0.34 $0.00 Ambu Bag w/mask-Adult 18696 $8.60 $0.00 Ambu Bag w/mask- Peds 37012 $15.00 $0.00 Ambu Bag w/mask- Infant cs/10 15071 $16.00 $0.00 CPAP mask $50.00 $0.00 Lg Bitrac Full Face Mask $29.00 $0.00 ET Tube Stylette 71671 $0.00 Wipes Disenfect 21190 $11.52 $0.00 Grand Total $114.33 St.Vincent Hospital&Healthcare Center, Invoice T- Attn: Carolyn Terry,Acct Rptg 10330 N. Meridian St., Suite 430 North DATE INVOICE# Indianapolis, IN 46290-1024 11/26/2013 13271 BILL TO Carmel Fire EMS Attn: Accounts Payable 2 Carmel Civic Square Carmel, IN 46032 TERMS Due on receipt DESCRIPTION AMOUNT EMS Supplies purchased October 2013 2,344.76 Medical Supplies $490.26 Transfer- Drugs 1,854.50 TOTAL: $2,344.76 See Attached Total $2,344.76 Inquiries: Carolyn Terry Payments/Credits $0.00 317.583.3301 cmterry @stvincent.org Balance Due $29344.76 Depatmental Transfer of Supplies date submissed 11/04/13 Zequesting Department: Carmel Fire Dept Supplying Department ER ,ost Center 8213 Cost Center 27230 ITEM# QUANTITY UNIT COST TOTAL COST klcohol preps 9219 $2.67 $0.00 i 4ngiocath 18g 1266 $1.50 $0.00 4ngiocath 20g 1264 10 $1.50 $15.00 gngiocath 22g 1262 $1.50 $0.00 Angiocath 24g 1261 $1.55 $0.00 Basin kidney shaped 10302 $0.08 $0.00 Basin round 10297 $0.31 $0.00 Cold paks 45779 $0.57 $0.00 EKG Electrodes 72104 $3.12 $0.00 Emesis Bags(per pack) 118984 $11.52 $0.00 EZ-10 Adult Needles $495.00/box of 5) $99.00 $0.00 Foam-Quikcare 5033 $2.67 $0.00 Guaze, 2 x 2 Cotton bail 9170 $1.88 $0.00 Gauze Kerlex 9217 8 $0.67 $5.36 Gloves-Med 985 $5.41 $0.00 Gloves-Large 986 $5.41 $0.00 Gloves-Xlarge 34059 $5.95 $0.00 IV Adapter, Luerlock 1260 $0.15 $0.00 IV Dial a flow 17477 $3.15 $0.00 IV Extension 19" 1223 $1.91 $0.00 IV Lock with Ext 1221 20 $1.87 $37.40 IV Start Kits(100/bx) 78663 35 $1.00 $35.00 IV Start Kits Sobraview(100/bx) 116570 25 $2.66 $66.50 IV Tubing 15 tt 486 $1.17 $0.00 Kerlix 4.5"x6p1 201627 $0.73 $0.00 Razor, dis oseable 910 $0.12 $0.00 Normal Saline 1000 cc bags/ca 446 $9.48 $0.00 Sca el#11 LUM1948 $1.30 $0.00 Sharps Container 23636 $4.59 $0.00 Sterile H2O bottle 384 $0.71 $0.00 Suction Canister&top 3634 $3.26 $0.00 Suture Kit 1 $1.09 $0.00 Syringe w/Needle 1 ml 2028 $0.07 $0.00 Syringe w/Needle 3 ml 2014 20 $0.05 $1.00 Syringe w/Needle 5ml 2030 $0.10 $0.00 Syringe w/Needle 10 ml 2031 $0.12 $0.00 'Syringe w Saline 3ml 105371 $0.28 $0.00 Syringe w/Salinel0ml 37350 $0.32 $0.00 30 ml saline vials(per box) 330 $9.63 $0.00 Tape 2" 6 rolls/box) 159 $1.00 $0.00 Tae 1" 158 $0.50 $0.00 Tape 2"cloth adh 181 $1.29 $0.00 Tape Trans ore 1/2" $1.28 $0.00 Ultra Trak Ultimate Test Control $83.30 Ultra Trak Ultimate Test Strips/10 BX 1 $330.00 $330.00 Warm paks 3416 $1.46 $0.00 Wound Cleanser 17344 $5.04 $0.00 Suction Canister&top 3634 $3.26 $0.00 Yankauers 9377 $0.34 $0.00 Ambu Bag w/mask-Adult 18696 $8.60 $0.00 Ambu Bag w/mask- Peds 37012 $15.00 $0.00 Ambu Bag w/mask- Infant cs/10 15071 $16.00 $0.00 CPAP mask $50.00 $0.00 Lg Bitrac Full Face Mask $29.00 $0.00 ET Tube Stylette 71671 $0.00 Wipes Disenfect 21190 $11.52 $0.00 Grand Total $490.26 Control Controll Control Contro12 TotalPic TotalPic1 02-8213 Carmel Fire Department Acetaminophen Tab 325 MG TYLENOL Tab 325 MG 3000 EA 7 $0.07 02-8213 Carmel Fire Department ADENOSINE INJ 6 MG ADENOSINE INJ 6 MG 2 ML 10 $164.60 02-8213 Carmel Fire Department Albuterol SULF NEB SOL(0.083%) ALBUTEROL SULFATE 0.083%NEB SOL(0.083%) 3 ML 29 $5.51 02-8213 Carmel Fire Department AMIODARONE HCL INJ 50 MGImL AMIODARONE HCL INJ 50 MG/mt- 3 ML 4 $23.24 02-8213 Carmel Fire Department AMIODARONE HGL INJ 50 MG/mL AMIODARONE HYDROCHLORIDE INJ 50 MG/mL 3 ML 21 $1638 02-8213 Carmel Fire Department Aspirin Tab Chew 81 MG ASPIRIN!Tab Chew 81 MG 750 EA 108 $3.24 02-8213 Carmel Fire Department Atropine Sulfate INJ-SYRNG 1 MG/10 mL ATROPINE SULFATE INJ-SYR 1 MG/10 mL 10 ML 17 $130.73 02-8213 Carmel Fire Department CALcium CHLORide INJ-SYRNG 100 MG/ml- CALcium CHLORide INJ-SYRNG 100 MG/mL 10 ML 3 $21.87 02-8213 Carmel Fire Department Dextrose-DOPamine INJ 400 MG/250 mL DEXTROSE/DOPamine HCL INJ 400 MG/250 mL 250 ML 1 $6.68 02-8213 Carmel Fire Department Dextrose INJ-SYRNG 25% DEXTROSE INJ-SYRNG 25% 10 ML 1 $4.96 02-8213 Carmel Fire Department Dextrose INJ-SYRNG 50% DEXTROSE INJ-SYRNG 50% 50 mL 6 $51.30 02-8213 Carmel Fire Department DiphenhydrAMINE INJ 50 MG/ml- DIPHENHYDRAMINE HYDROCHLORIDE INJ 50 MG/mL 1 ML 6 $4.20 02-8213 Carmel Fire Department EpiNEPHrine HCL INJ 0.1 MG/mL EPINEPHRINE HCL-3-1/2in INJ 0.1 MG/ml- 10 ML 6 $20.46 02-8213 Carmel Fire Department EpiNEPHrine HCL INJ 0.1 MG/ML EPINEPHRINE HCL INJ 0.1 MG/ML 10 ML 13 $55.90 02-8213 Carmel Fire Department Epinephrine INJ 1 MG/ML EpiNEPHrine INJ 1 MG/ML 30 ML 1 $2.54 02-8213 Carmel Fire Department FentaNYL INJ 100 MCG/2 mL FENTANYL CITRATE INJ 100 MCG/2 mL 2 ML 5 $3.75 02-8213 Carmel Fire Department Glucagon INJ 1 MG GLUCAGEN DIAG.KIT INJ 1 MG 1 EA 11 $1,134.76 02-8213 Carmel Fire Department Glucose(Dextrose)GEL 40% GLUTOSE 15 GEL 40% 15 GM 7 $40.67 02-8213 Carmel Fire Department Ipratropium SOL 0.02% IPRATROPIUM BROMIDE SOL 0.02% 2.5 ML 3 $0.48 02-8213 Carmel Fire Department Ketorolac INJ 60 MG/2 mL KETOROLAC TROMETHAMINE INJ 60 MG/2 mL 2 ML 1 $0.68 02-8213 Carmel Fire Department Lidocaine HCL INJ-SYRNG 100 MG LIDOCAINE HCL INJ-SYRNG 100 MG 5 ML 7 $30.10 02-8213 Carmel Fire Department Lidocaine HCL JELLY 2%30 GM LIDOCAINE JELLY 2%JELLY 2%30 GM 30 2 $11.26 02-8213 Carmel Fire Department MIDAZOLAM INJ 10 MG/2 mL MIDAZOLAM HCL INJ 10 MG/2 mL 2 ML 5 $4.20 02-8213 Carmel Fire Department Naloxone INJ 1 MG/ML NALOXONE HYDROCHLORIDE INJ 1 MG/ML 2 ML 4 $52.24 02-8213 Carmel Fire Department Naloxone SRN**CARMEL" NALOXONE HCL SRN**CARMEL** 1 ML 2 $3.58 02-8213 Carmel Fire Department Nitroglycerin Tab 0.4 MG NITROSTAT Tab 0.4 MG 25 1 $9.34 02-8213 Carmel Fire Department Ondansetron INJ 2 mg/mL ONDANSETRON INJ 2 mg/mL 2 ML 21 $6.72 02-8213 Carmel Fire Department Ondansetron Tab ODT 4 MG ONDANSETRON Tab ODT 4 MG 30 EA 19 $3.04 02-8213 Carmel Fire Department SODium CHLORide INJ 0.9%1000 mL SODium CHLORide 0.9%INJ 0.9%1000 mL 1000 ML 32 $25.28 02-8213 Carmel Fire Department SODium CHLORide INJ 0.9%50 mL SODium CHLORide 0.9%INJ 0.9%50 mL 50 ML 4 $8.36 02-8213 Carmel Fire Department SODium CHLORide INJ 0.9%500 mL SODium CHLORide 0.9%INJ 0.9%500 mL 500 ML 11 $8.36 $1,854.50 VOUCHER NO. WARRANT NO. ALLOWED 20 St. Vincent Hospital Attn: Carolyn Terry, Acct. Reporting IN SUM OF $ 10330 N. Meridian Street, Ste. 430 N Indianapolis, IN 46290 $3,152.01 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1120 13271 102-390.11 $2,344.76 1 hereby certify that the attached invoice(s), or 1120 13270 102-390.11 $807.25 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 BEE 16 2015 Fire Chief Title Cost distribution ledger classification if claim paid motor vehicle highway fund 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)) 13271 $2,344.76 13270 $807.25 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