HomeMy WebLinkAbout250808 10/21/15 4�!..4�F,y�!
CITY OF CARMEL, INDIANA VENDOR: 368918
( ® ��; ONE CIVIC SQUARE PENN CARE INC. CHECK AMOUNT: $""'1,429.65"
,�� a CARMEL, INDIANA 46032 1317 NORTH ROAD CHECK NUMBER: 250808
+M��_�_' NILES OH 44446 CHECK DATE: 10/21/15
��ON
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
102 4239011 86262 1,429.65 SPECIAL DEPT SUPPLIES
Invoice
1317 North Road
PO: Tom
• � �:> Niles, OH 44446
® - Order Date. 9/29/2015
-.. J 800-392-7233
Public Safety Technology sales@penncare.net Invoice Date: 9/29/2015
Terms: Net 30
Ship, Method: UPS Ground
Bill To: Ship To:
Carmel Fire Dept. Carmel Fire Dept.
540 W 136 st 540 W 136 st
Carmel, IN 46032 Carmel, IN 46032
Carmel Fire Dept.
50 50 0 AM-SPOOS50 Electrode, adult foam 38mm, 12.00 bag/50 600.00 -/
50/pkg
5 5 0 KEN-518441 Combitube roll up kit 41FR 53.00 each 265.00
12 12 0 AM-420211000 Adult BVM in bag, SPUR II 11.00 each 132.00 V
2 2 0 EMI-3228 Deluxe Finger Ring Cutter 16.00 each 32.00 -/
4 4 0 MM-0965NL Sealed OB Kits 8.00 each 32.00 V
25 25 0 MD-GZM001 Multi trauma dressing 1.35 each 33.75 -/
1 1 0 DY-4110 Disp scalpel w/handle #10-bx/10 4.75 box/10 4.75 -V
5 5 0 MD-SC8 Suction catheter, 8FR 0.35 each 1.75 -/
20 20 0 MF-296M Gloves, MidKnight Nitrile Medium 10.62 each 212.40 V
bx/100
4 4 0 NAR-300023 C-A-T--Combat Application 29.00 each 116.00 -V
Tourniquet Rescue Orange
$1,429.65
Subtotal $1,429.65
- Shipping
Tax @
TOTAL $1,429.65
Payments
Credits
e
Page 1 of 1
I
VOUCHER NO. WARRANT NO.
ALLOWED 20
Penn Care Inc.
IN SUM OF$
1317 North Road
i
Niles, OH 44446
I
$1,429.65
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#!TITLE AMOUNT Board Members
1120 86262 102-390.11 $1,429.65 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
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No.201(Rev.1995)
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))
86262 $1,429.65
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