258500 05/10/16 CITY OF CARMEL, INDIANA VENDOR: 368918
CHECK AMOUNT: $*****2,400.46*
"�,• ONE CIVIC SQUARE PENN CARE INC.
CARMEL, INDIANA 46032 1317 NORTH ROAD CHECK NUMBER: 258500
,,ETON NILES OH 44446 CHECK DATE: 05/10/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
102 4239011 90265 1,316.98 SPECIAL DEPT SUPPLIES
102 4239011 90299 600.00 SPECIAL DEPT SUPPLIES
102 4239011 90308 169.98 SPECIAL DEPT SUPPLIES
102 4239011 90334 104.50 SPECIAL DEPT SUPPLIES
102 4239011 90335 209.00 SPECIAL DEPT SUPPLIES
VOUCHER NO. WARRANT NO. Prescribed by state Board of Accounts City Form No.201(Rev.1995)
ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
PENN CARE INC.
1317 NORTH ROAD IN SUM OF$ CITY OF CARMEL
An invoice or bill to be properly itemized must show:kind of service,where performed,dates service rendered,by
NILES,OH 44446 whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
$2,086.96 Payee
Purchase Order No.
ON ACCOUNT OF APPROPRIATION FOR
Terms
Carmel Fire
Date Due
Invoice Date Invoice# Description Amount
PO#/Dept. INVOICE NO. ACCT#/Fund AMOUNT Board Members Dept. Fund# (or note attached invoice(s)or bill(s))
90308 42-390.11 $169.98 1 hereby certify that the attached invoice(s),or 04/29/16 90308 $169.98
102 102 102 102
90265 42-390.11 $1,316.98 bill(s)is(are)true and correct and that the 04/29/16 90265 $1,316.98
102 102 materials or services itemized thereon for 102 102
90299 42-390.11 $600.00 04/29/16 90299 $600.00
102 102 which charge IS made were ordered and 102 102
received except
Monday,May 02,2016
U®r 'Z-�. �. �
David Haboush
Fire Chief
Cost distribution ledger classification if I hereby certify that the attached invoice(s),or bill(s),is(are)true and correct and I have audited same in accordance
claim paid motor vehicle highway fund with IC 5-11-10-1.6
,20
Clerk-Treasurer
Invoice #90308
1317 North Road
Niles, OH 44446 PO: Tom Small
� 800-392-7233 Order Date: 4/27/2016
Public Safety Technology sales@penncare.net Invoice Date: 4/29/2016
r Terms: Net 30
Ship Method: UPS Ground
Bill To: Ship To:
Carmel Fire Department Carmel Fire Department
Tom Small Tom Small
2 Civic Square 540 W 136 st
Carmel, IN 46032 Carmel, IN 46032
• Ship'd •
'd Code Name Price Unit Ext Price Tax
Carmel Fire Department
6 6 0 AM-430014000 BVM Pedi disp w/3 masks 28.33 each 169.98 -/
$169.98
Subtotal $169.98
Shipping
Tax @
TOTAL $169.98
Payments
Credits
Balance Due, $169.98
Page 1 of 1
Invoice #90265
1317 North Road
f` PO: Tom Small
R Niles OH 44446
�- 800-392-7233 Order Date: 4/27/2016
Public Safety Technology sales@penncare.net Invoice Date: 4/27/2016
Terms: Net 30
Ship Method: UPS Ground
Bill To: Ship To:
Carmel Fire Department Carmel Fire Department
Tom Small Tom Small
2 Civic Square 540 W 136 st
Carmel, IN 46032 Carmel, IN 46032
• e e Ship'd • e Cod.e
Carmel Fire Department
12 12 0 AM-420211000 Adult BVM in bag, SPUR II 11.00 each 132.00 -/
12 6 6 AM-430014000 BVM Pedi disp w/3 masks 28.33 each 169.98 -/
10 10 0 PC-1057209 Flow-Safe II CPAP with Large Adult 59.00 each 590.00 V
50 50 0 LA-980010 Collar, Stifneck Select Adult 8.50 each 425.00 -/
$1,316.98
Subtotal $1,316.98
Shipping
Tax @
TOTAL $1,316.98
Payments
Credits
Balance Due, $1,316.98 ,
Page 1 of 1
Invoice #90299
1317 North Road
PO:
Niles, OH 44446
■�b11e� 800-392-7233 Order Date: 3/22/2016
PublicSafety Technology sales@penncare.net Invoice Date: 4/28/2016
i Terms: Net 30
Ship Method: Drop Ship
Bill To: Ship To:
Carmel Fire Department Carmel Fire Department
2 Civic Square 2 Civic Square
Carmel, IN 46032 Carmel, IN 46032
• • • • • • Code
Carmel Fire Department
2 2 0 PLC-1550EMS Pelican case #1550 w/foam div/lid 300.00 each 600.00 -/
organzr
BLACK
$600.00
Subtotal $600.00
Shipping
Tax @
TOTAL $600.00
Payments
Credits
Ballbince Due $600.00
Page 1 of 1
VOUCHER NO. WARRANT NO. Prescribed by state Board of Accounts City Form No.201(Rev.1995)
ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
PENN CARE INC.
1317 NORTH ROAD IN SUM OF$ CITY OF CARMEL
An invoice or bill to be properly itemized must show:kind of service,where performed,dates service rendered,by
NILES,OH 44446 whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
$313.50 Payee
Purchase Order No.
ON ACCOUNT OF APPROPRIATION FOR
Terms
Carmel Fire
Date Due
Invoice Date Invoice# Description Amount
PO#/Dept. INVOICE NO. ACCT#/Fund AMOUNT Board Members Dept. Fund# (or note attached invoice(s)or bill(s))
90334 42-390.11 $104.50 05/03/16 90334 $104.50
` �� I hereby certify that the attached invoice(s),or 102 102
F102 X102
//. 90335 42-390.11 $209.00 bill(s)is(are)true and correct and that the 05/03/16 90335 $209.00
materials or services itemized thereon for 102 1 102
which charge is made were ordered and
received except
Tuesday,May 03,2016
David Haboush
Fire Chief
Cost distribution ledger classification if I hereby certify that the attached invoice(s),or bill(s),is(are)true and correct and I have audited same in accordance
claim paid motor vehicle highway fund with IC 5-11-10-1.6
,20
Clerk-Treasurer
Invoice #90335
,i 1317 North Road
Niles, OH 44446 PO'
800-392-7233 Order Date: 4/27/2016
Public Safety Technology sales@penncare.net Invoice Date: 5/2/2016
Terms: Net 30
Ship Method: Drop Ship
Bill To: Ship To:
Carmel Fire Department Carmel Fire Department
2 Civic Square 2 Civic Square
Carmel, IN 46032 Carmel, IN 46032
• . . o • a Code Name Price Unit Ext Price Tax
Carmel Fire Department
2 2 0 MT-M5105 G2 PRO Grab 2 Go Quick Aid 104.50 each 209.00
System
$209.00
Subtotal $209.00
Shipping
Tax @
TOTAL $209.00
Payments
Credits
Balance Due • i
Page 1 of 1
Invoice #90334
1317 North Road
Niles, OH 44446 PO:
800-392-7233 Order Date: 4/14/2016
Public Safety Technology sales@penncare.net Invoice Date: 5/2/2016
�i Terms: Net 30
Ship Method: Drop Ship
Bill To: Ship To:
Carmel Fire Department Carmel Fire Department
2 Civic Square 2 Civic Square
Carmel, IN 46032 Carmel, IN 46032
• . . . . • Code Name Price Unit Ext Price Tax
Carmel Fire Department
1 1 0 MT-M5105 G2 PRO Grab 2 Go Quick Aid 104.50 each 104.50
System
$104.50
Subtotal $104.50
Shipping
Tax @
TOTAL $104.50
Payments
Credits
Balance Due $104.50
Page 1 of 1