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308633 02/28/17 CITY OF CARMEL, INDIANA VENDOR: 368918 ® \• ONE CIVIC SQUARE PENN CARE INC. CHECK AMOUNT: 5"t"`1,337.95• CARMEL, INDIANA 46032 1317 NORTH ROAD CHECK NUMBER: 308633 M_ioN NILES OH 44446 CHECK DATE: 02/28/17 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 102 4239011 4239011 500.85 SPECIAL DEPT SUPPLIES 102 4239011 96485 426.00 -' SPECIAL DEPT SUPPLIES 102 4239011 96652 44.10 SPECIAL DEPT SUPPLIES 1120 4239011 96705 192.00 SPECIAL DEPT SUPPLIES 102 4239011 96790 63.00 SPECIAL DEPT SUPPLIES 102 4239011 96861 112.00 SPECIAL DEPT SUPPLIES VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) Vendor# 368918 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER PENN CARE INC. IN SUM OF$ CITY OF CARMEL 1317 NORTH ROAD 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. NILES, OH 44446 Payee $112.00 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 96861 42-390.11 $112.00 1 hereby certify that the attached invoice(s),or 2/21/17 96861 $112.00 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 Tuesday, February 21,2017 V4mD �. �,A 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 #96861 1317 North Road PO: - :rte IFF Niles, OH 44446 800-392-7233 Order Date: 2/16/2017 Many Needs...One Solution sales@penncare.net Invoice Date: 2/20/2017 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 32 32 0 KEN-LP11 Lifepak 11 & 12 & 15 Paper 3.50 each 112.00 4-3/16" x 73' (10.6 cm x 22.3 m) $112.00 Subtotal $112.00 Shipping Tax @ TOTAL $112.00 Payments Credits • - $112.00, Page 1 of 1 VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995) Vendor#* 368918 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER PENN CARE INC. IN SUM OF$ CITY OF CARMEL 1317 NORTH ROAD 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. NILES, OH 44446 Payee $1,225.95 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 96652 42-390.11 $44.10 I hereby certify that the attached invoice(s),or 2/17/17 96652 $44.10 1120 102 1120 102 96705 42-390.11 $192.00 bill(s)is(are)true and correct and that the 2/17/17 96705 $192.00 1120 102 materials or services itemized thereon for 1120 102 96790 42-390.11 $63.00 2/17/17 96790 $63.00 1120 102 which charge is made were ordered and 1120 102 96485 42-390.11 $426.00 received except 2/17/17 96485 $426.00 1120 102 1120 102 96539 42-390.11 $500.85 2/17/17 96539 $500.85 1120 102 1120 102 42-390.11 2/17/17 1120 102 1120 102 Friday, February 17,2017 U®r 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 Iry®ice #96S39 :ff 1317 North Road PO: TomPayne f Niles, OH 44446 .� _ 800-392-7233 Order Date: 2/7/2017 Pansy eeds...One Solution sales@penncare.net Invoice Date: 2/7/2017 Terms: Net 30 Ship Method: UPS Ground Bill To: Ship To: Carmel Fire Department Carmel Fire Department Tom Payne Tom Payne 2 Civic Square 2 Civic Square Carmel, IN 46032 Carmel, IN 46032 Carmel Fire Department 12 4 8 RU-4000 Oral Airway Kit, Berman, Set/6 4.50 kit 18.00 -/ 1 1 0 DY-128 Lubricating Jelly Packets, Sterile 13.75 box/144 13.75 -/ 144/box 100 50 50 LA-980010 Collar, Stifneck Select, Adult 8.50 each 425.00 36 18 18 3M-1582 Coban Self Adherent Wrap, 2" x 5yds, 2.45 each 44.10 'V Tan $500.85 Subtotal $500.85 Shipping Tax @ TOTAL $500.85 Payments Credits Page 1 of 1 Inv®ice #96485 5 1317 North Road PO: Niles, OH 44446 Order Date: 1/24/2017 800-392-7233 many eeds...One Solution sales@penncare.net Invoice Date: 2/3/20.17 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 __ €d- rs.a.,w,v a�� "� m�-'�a `�"k,%,�.. a.�.. a,.,",.�„�„1�.�^;�4'' se"�' � ,��o#.c€"tis 3'"...,.z..�� `� .., •a ...,.E...'t” Carmel Fire Department 6 6 0 MPC-11996000340 Sensor, Physio-Control LIFEPAK 15 71.00 each 426.00 Masimo SET RC R20 Rainbow, Disposable $426.0.0 Subtotal $426.00 Shipping Tax @ TOTAL. $426.00 Payments Credits Page 1 of 1 Invoice #96790 1317 North Road� PO: Pm � YEAR- Niles, OH 44446 800-392-7233 Order Date: 2/16/2017 .; Many Needs...One Solution sales@penncare.net Invoice Date: 2/16/2017 Terms: Net 30 Y- 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 • • - - - Tax Carmel Fire Department 50 18 32 KEN-LP11 Lifepak 11 & 12 & 15 Paper 3.50 each 63.00 4-3/16" x 73' (10.6 cm x 22.3 m) $63.00 Subtotal $63.00 Shipping Tax @ TOTAL $63.00 Payments Credits Ballppce Due •0 T. Page 1 of 1 Invoice #96705 1317 North Road PO: Niles, OH 44446 2017 3 2 Order Date: 1 800-392-7233 / / Many Needs...One Solution sales@penncare.net Invoice Date: 2/13/2017 Terms: Net 30 Y 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 N-a.me Price Unit, Ext Price Tax Carmel Fire Department 12 12 0 ARK-530050 Multi Test Strips, Arkray Assure Prism, 16.00 bottle 192.00 50/bottle $192.00 Subtotal $192.00 Shipping Tax @ TOTAL $192.00 Payments Credits Balance • - a0 Page 1 of 1 Invoice #96652 1317 North Road Niles, OH 44446 PO: Tom Payne PC ®s: i�- 800-392-7233 Order Date: 2/7/2017 ManyNeeds...One Solution sales@penncare.net Invoice Date: 2/10/2017 _ Terms: Net 30 Ship Method: UPS Ground Bill To: Ship To: Carmel Fire Department Carmel Fire Department Tom Payne Tom Payne 2 Civic Square 2 Civic Square Carmel, IN 46032 Carmel, IN 46032 Carmel Fire Department 18 18 0 3M-1582 Coban Self Adherent Wrap, 2" x 5yds, 2.45 each 44.10 -/ Tan $44.10 Subtotal $44.10 Shipping Tax @ TOTAL $44.10 Payments Credits .u- Page 1 of 1