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301108 07/25/16 's c,xM a`��\ CITY OF CARMEL, INDIANA VENDOR: 368918 �5 i1 ONE CIVIC SQUARE PENN CARE INC. CHECK AMOUNT: $*****3,046.38* �_�, CARMEL, INDIANA 46032 1317 NORTH ROAD CHECK NUMBER: 301 108 �,1PoN'� NILES OH 44446 CHECK DATE: 07/26/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 102 4239011 91829 1,440.75 SPECIAL DEPT SUPPLIES 102 4239011 91904 862.60 SPECIAL DEPT SUPPLIES 102 4239011 91964 89.55 SPECIAL DEPT SUPPLIES 102 4239011 92017 653.48 SPECIAL DEPT SUPPLIES VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995) PENN CARE INC. ALLOWED 20 ACCOUNTS PAYABLE VOUCHER 1317 NORTH ROAD IN SUM OF$ CITY OF CARMEL An invoice or bill to be properly itemized must show:kind of service,where performed,dates service NILES, OH 44446 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc. $2,392.90 Payee Purchase Order# ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Terms Date Due PO# ACCT# DATE INVOICE# DESCRIPTION DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT 91829 42-390.11 $1,440.75 1 hereby certify that the attached invoice(s),or 7/18/16 91829 $1,440.75 1120 102 1120 102 91904 42-390.11 $862.60 bill(s)is(are)true and correct and that the 7/18/16 91904 $862.60 1120 102 materials or services itemized thereon for 1120 1 102 I 91964 I 42-390.11 I $89.55 7/18/16 I 91964 I $89.55 1120 102 which charge is made were ordered and 1120 102 received except Monday,July 18,2016 David Haboush Fire Chief 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- Cost 20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer Invoice #91829 1317 North Road PO: tom small Niles, OH 44446 ■E �L 800-392-7233 Order Date: 7/11/2016 Public Safety Technology, sales@penncare.net Invoice Date: 7/11/2016 Terms: Net 30 Ship Method: UPS Ground Bill To: Ship To: Carmel Fire Department Carmel Fire Department 2 Civic Square 540 W 136 Street Carmel, IN 46032 Carmel, IN 46032 • • a ' Code ka Me Price :Unit Ext'Price Tax; Carmel Fire Department 10 10 0 GF-51926 MegaMover portable Transport Unit, 25.99 each 259.90 white/black, 40"x 80" 10 10 0 MD-MSPLINT Flex-All splint orange (SAM SPLINT) 6.00 each 60.00 48 48 0 DK-8503 Gauze, 4" X 4" 12ply, 2/pk, 25pk/bx 2.50 tray/25 120.00 20 20 0 PC-0070 ET Tube, Cuffed, 7.Omm 1.35 each 27.00 20 20 0 PC-0080 ET Tube, Cuffed, 8.Omm 1.35 each 27.00 20 20 0 MPC-11996000091 Edge System Quick-Combo pads 33.00 pair 660.00 30 30 0 LA-980010 Collar, Stifneck Select Adult 8.50 each 255.00 10 10 0 RU-121804 Airway, Berman Oral, 90mm Yellow 0.20 each 2.00 20 5 15 MM-6125 Bag, Biohazard 4 Gallon 10/pkg 5.97 pack/10 29.85 100 0 100 RG-60418 Bag, 10 gallon biohazard, pkg/10 5.00 pack/10 0.00 $1,440.75 Subtotal $1,440.75 Shipping Tax @ TOTAL $1,440.75 Payments Credits Balance Due $1,440.75 Page 1 of 1 Invoice #91904 1317 North Road Niles, OH 44446 PO: tom small ■` � 800-392-7233 Order Date: 7/13/2016 Public Safety Technology sales@penncare.net Invoice Date: 7/13/2016 Terms: Net 30 Ship Method: UPS Ground Bill To: Ship To: Carmel Fire Department Carmel Fire Department 2 Civic Square 540 W 136 Street Carmel, IN 46032 Carmel, IN 46032 OrdT'id Sh-i-p'd BO'dCode Name Price Unit Ext Price Tax Carmel Fire Department 80 80 0 MF-296L Gloves, MidKnight Nitrile Large bx/100 10.62 each 849.60 2 2 0 ADC-351 Penlights, Disposable, 6/pack 6.50 pack/6 13.00 $862.60 Subtotal $862.60 Shipping Tax @ TOTAL $862.60 Payments Credits Balance Due Page 1 of 1 Invoice #91964 1317 North Road PO: tom small Niles, OH 800-392-7233 6 Order Date: 7/11/2016 Public Safety Technology sales@penncare.net Invoice Date: 7/15/2016 =y% Terms: Net 30 Ship Method: UPS Ground Bill To: Ship To: Carmel Fire Department Carmel Fire Department 2 Civic Square 540 W 136 Street Carmel, IN 46032 Carmel, IN 46032 . Code Name Price Unit Ext Price Tax Carmel Fire Department 15 15 0 MM-6125 Bag, Biohazard 4 Gallon 10/pkg 5.97 pack/10 89.55 $89.55 Subtotal $89.55 Shipping Tax @ TOTAL $89.55 Payments Credits Balance Due Page 1 of 1 VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995) ALLOWED 20 ACCOUNTS PAYABLE VOUCHER PENN CARE INC. 1317 NORTH ROAD IN SUM OF$ CITY OF CARMEL An invoice or bill to be properly itemized must show:kind of service,where performed,dates service NILES, OH 44446 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc. $653.48 Payee Purchase Order# ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Terms Date Due PO# ACCT# DATE INVOICE# DESCRIPTION DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT 92017 42-390.11 $653.48 1 hereby certify that the attached invoice(s),or 7/19/16 92017 $653.48 1120 102 1120 102 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 Tuesday,July 19,2016 David Haboush Fire Chief 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 5-11-10-1.6 120- Cost 20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer Invoice #92017 1317 North RoadNilePO: ■� �� 8005392-723OH 43 6 Order Date: 7/18/2016 Public SafeWTechnology sales@penncare.net Invoice Date: 7/18/2016 .r Terms: Net 30 Ship Method: UPS Ground Bill To: Ship To: Carmel Fire Department Carmel Fire Department 2 Civic Square 2 Civic Square Carmel, IN 46032 Carmel, IN 46032 • . BWd Code Carmel Fire Department 12 12 0 RU-008622300 Laryngoscope Bulb, Large 4.30 each 51.60 -/ 12 12 0 RU-008623100 Laryngoscope Bulb, Small 4.30 each 51.60 N/ 48 10 38 RF-4332 Bandage, 6" Israeli 9.20 each 92.00 -/ 50 50 0 LA-980010 Collar, Stifneck Select, Adult 8.50 each 425.00 -/ 12 4 8 ADC-675BK Stethoscope, PROSCOPE Dual Head, 8.32 each 33.28 -/ Black Pediatric 6 0 6 ADC-770 Blood Pressure Cuff, Adult Cotton, Grafi 25.80 each 0.00 _/ $653.48 Subtotal $653.48 Shipping Tax @ TOTAL $653.48 Payments Credits Balance Due $653.48 Page 1 of 1