305258 11/14/16 0�/,F�N�R!
CITY OF CARMEL, INDIANA VENDOR: 368918
ONE CIVIC SQUARE PENN CARE INC. CHECK AMOUNT: $*****1,340.50*
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CARMEL, INDIANA 46032 1317 NORTH ROAD CHECK NUMBER: 305258
M,�iori. NILES OH 44446 CHECK DATE: 11/14/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
102 4239011 94169 1,263.00 SPECIAL DEPT SUPPLIES
102 4239011 94312 77.50 SPECIAL DEPT SUPPLIES
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995)
PENN CARE INC. ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
1317 NORTH ROAD IN SUM OF$ 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.
$1,263.00 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
94169 42-390.11 $1,263.00 1 hereby certify that the attached invoice(s),or 11/3/16 94169 $1,263.00
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
Friday, November 04,2016
V4"'®r '_z�
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
1317 North Road
Niles OH 44446 PO'
800-392-7233 Order Date: 10/25/2016
Many Needs...One Solution sales@penncare.net Invoice Date: 10/25/2016
Terms: Net 30
Ship Method: UPS Ground
Sill To: Ship To:
Carmel Fire Department Carmel Fire Department
2 Civic Square 540 W 136 Street
Carmel, IN 46032 Carmel, IN 46032
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.�, �." .,fr<..<...,,. •••�°>. ,.u.,.....,..w,..
Carmel Fire Department
24 24 0 MD-MSPLINT Splint, Flex-All, Orange (SAM SPLINT) 6.00 each 144.00 -/
2 2 0 GM-3001 Hot Pack, Instant, 5"X 9", 24/box 14.25 box/24 28.50 -V
50 50 0 MF-296L Gloves, MidKnight Nitrile, L, 100/box 10.62 each 531.00 -/
10 10 0 GF-53376 MegaMover Plus, 40"x 80" 33.00 each 330.00 -/
10 10 0 PC-0070 ET Tube, Cuffed, 7.Omm 1.35 each 13.50 -/
50 40 10 DMS-30051Y Backboard Strap, Disposable Vinyl 5.40 set 216.00
Sticky, Yellow
$1,263.00.
Subtotal $1,263.00
Shipping
Tax @
TOTAL $1,263.00
Payments
Credits
T .
Page 1 of 1
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995)
PENN CARE INC. ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
1317 NORTH ROAD IN SUM OF$ 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.
$77.50 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
94312 42-390.11 $77.50 1 hereby certify that the attached invoice(s),or 11/8/16 94312 $77.50
1120 /-1-02 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, November 08, 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 #94312
1317 North Road
7 Niles, OH 44446 PO'
800-392-7233 Order Date: 11/1/2016
Many Needs...One Solution sales@penncare.net Invoice Date: 11/1/2016
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
25 25 0 HUD-5080 Oxygen Wrench, Aluminum 3.10 each 77.50
$77.50
Subtotal $77.50
Shipping
Tax @
TOTAL. $77.50
Payments
Credits
2i6�1-
Page 1 of 1