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304726 10/31/16 CITY OF CARMEL, INDIANA VENDOR: 368918 `fid ,1 ONE CIVIC SQUARE PENN CARE INC. CHECK AMOUNT: $*****1,527.32* CARMEL, INDIANA 46032 1317 NORTH ROAD CHECK NUMBER: 304726 NILES OH 44446 CHECK DATE: 10/31116 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 102 4239011 93617 193.00 SPECIAL DEPT SUPPLIES 102 4239011 93703 850.00 SPECIAL DEPT SUPPLIES 102 4239011 93724 96.32 SPECIAL DEPT SUPPLIES 102 4239011 93768 315.00 SPECIAL DEPT SUPPLIES 102 4239011 94040 73.00 SPECIAL DEPT SUPPLIES VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) PENN CARE INC. ALLOWED 20 ACCOUNTS PAYABLE VOUCHER 1317 NORTH ROAD IN SUM OF$ 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. $1,358.00 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 93703 42-390.11 $850.00 1 hereby certify that the attached invoice(s),or 10/12/16 93703 $850.00 1120 102 1120 102 93617 42-390.11 $193.00 bill(s)is(are)true and correct and that the 10/12/16 93617 $193.00 1120 1 1 102 1 materials or services itemized thereon for 1120 1 102 93768 I 42-390.11 I $315.00 10/12/16 I 93768 I I $315.00 1120 10 2 which charge is made were ordered and 1120 102 received except Thursday, October 13,2016 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 #93617 1317 North Road pO: tom small Niles, OH 44446 800-3922-7233 Order Date: 9/29/2016 � Many Needs...One Solution sales@penncare.net Invoice Date: 9/29/2016 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 Street Carmel, IN 46032 Carmel, IN. 46032 Carmel Fire Department 40 20 20 KEN-8970 Sharps, 2 gallon Rotor Lid, Red 3.65 each 73.00 -/ 10 10 0 EMI-1080B Shears, 7 1/4" Black 4.20 each 42.00 -/ 24 24 0 MD-MS64250 Sharps Dart (Shuttle) 2.95 each 70.80 24 24 0 MD-MSTR140 Triangular Bandage 0.30 each 7.20 -/ $193.00 Subtotal $193.00 Shipping Tax @ TOTAL $193.00 Payments Credits Page 1 of 1 Invoice 1317 North Road Niles, OH 44446 ®' a g W WRE1 800-392-7233 Order Date: 10/3/2016 Many sales@penncare.net Invoice Date: 10/3/2016 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 Carmel Fire Department . 100 100 0 LA-980010 Collar, Stifneck Select, Adult 8.50 each 850.00 $850.00 Subtotal $850.00 Shipping Tax @ TOTAL $850.00 Payments . Credits Page 1 of 1 Invoice 7 1317 North Road P®: Niles, OH 44446 ' w 800-392-7233 Order Date: 10/5/2016 Many Needs...One Solution sales@penncare.net Invoice Date: 10/5/2016. . Teirms: Nei'30 Ship Method: UPS Ground Sill To: Ship To: Carmel Fire Department Carmel Fire Department - 2 Civic Square .2 Civic Square Carmel, IN 46032 Carmel, IN 46032 e*,w.rm_,........,w...,....,.........Jawaw..ro %x?x...,:xz,_..o,...µ._,.....,er' ^waaw°i we.,....,....,...__.�.,c... ''�s.`.�'u..x.�..w.�ama:-.T• ,aw,..,.,,....a a_-a�'a.As.�;a£s«�oaera ,.,�.....,.w... .............:e.. ..:.,n _.,.,,._� ,........�_ Carmel Fire Department 10 10 0 MDS-5085 Gloves, Exam Powder-Free Textured 10.50 box 105.00 -V Nitrile, Pink with Aloe, M 10 10 0 MDS-5086 Gloves, Exam Powder-Free Textured 10.50 box 105.00 Nitrile, Pink with Aloe, L 10 10 0 MDS-5087 Gloves, Exam Powder-Free Textured 10.50 box 105.00 -V Nitrile, Pink with Aloe, XL $315.00 Subtotal $315.00 Shipping Tax @ TOTAL $315.00 Payments Credits v ti '7 Page Page 1 of 1 VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995) PENN CARE INC. ALLOWED 20 ACCOUNTS PAYABLE VOUCHER 1317 NORTH ROAD IN SUM OF$ 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. $169.32 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 93724 42-390.11 $96.32 I hereby certify that the attached invoice(s),or 10/24/16 93724 $96.32 1120 102 1120 102 94040 42-390.11 $73.00 bill(s)is(are)true and correct and that the 10/24/16 94040 $73.00 112002 materials or services itemized thereon for 1120 102 which charge is made were ordered and received except Monday, October 24,2016 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 #94040 1317 North Road p0: tom small .. Niles, OH 44446 -- • .• 1 800-392-7233 Order Date: 9/29/2016 Many Needs...One Solution sales@penncare.net Invoice Date., 10/18/2016 Terms: Net 30 Ship Method.,-UPS Ground Sill To: Ship To: Carmel Fire Department Carmel Fire Department Tom Small Tom Small 2 Civic Square 540 W 136 Street Carmel, IN 46032 Carmel, IN 46032 ~Carmel Fire Department 20 20 0 KEN-8970 Sharps, 2 gallon Rotor Lid, Red 3.65 each 73.00 $73.00 Subtotal $73.00 Shipping Tax @ TOTAL $73.00 Payments Credits Page 1 of 1 Iry®ice #93724 1317 North Road P®: ��" Niles, OH 44446 � = 800-392-7233 Order Date: 10/4/2016 Many Needs...One Solution sales@penncare.net Invoice Date: 10/4/2016 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 Carmel Fire Department 2 2 0 SS-80635 Replacement battery for VX-2 43.00 each 86.00 $86.00 Subtotal $86.00 Shipping $10.32 Tax @ TOTAL $96.32 Payments Credits Page 1 of 1