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316263 9/26/2017 u ��"'� CITY OF CARMEL, INDIANA VENDOR: 368918 ® ONE CIVIC SQUARE PENN CARE INC. CHECK AMOUNT: $*****3,1 15.00" `?4; CARMEL, INDIANA 46032 1317 NORTH ROAD CHECK NUMBER: 316263 9.oN�° CHECK DATE: 09/26/17 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 102 4239011 M10055. 01 81.00 SPECIAL DEPT SUPPLIES 102 4239011 M10079 450.20 SPECIAL DEPT SUPPLIES 102 4239011 M10250 514.40 SPECIAL DEPT SUPPLIES 102 4239011 M10253 734.50 SPECIAL DEPT SUPPLIES 102 4239011 M10283 767.40 SPECIAL DEPT SUPPLIES 102 4239011 M10283 .01 500.00 SPECIAL DEPT SUPPLIES 102 4239011 M9736. 02 67.50 SPECIAL DEPT SUPPLIES o z -0 « « } / \ 3 m / 2 k 2 U 2 2 0 n } 0 0 ? ® \ ? � q CF) m ƒ . § \ k / q 0 k O > 00 § \ O / a) - 0 k / \ § [ / q / 3 ~2 _ m ] - CL � z a 3 2 / 40K 9 j / } | o ¥ & . J # 3 LT - z > k 0 $ ID ? E k w % ' 0 £ / ƒ E o s @ k § cn 2 , # CL m f k m ® f 2 7 ® w / a � 2 + - k 7 n M . E % ƒ G » k / \ 0 k k E _ a) ƒ 2 CD { E / E m - < ; ` \ / $ ® CL § § o E cr c | r_ = e a y \I 2 m § E s ƒ § _ ® 0 w _ m \ E 0. ; CD / or 0 / _ 0 C-) \ z 0 S 0 \ gCD \ § m ƒ 7 = a ( ( ° ® ■ \ 2 C Z > kI � 0 9CL %\ } � b/ / e 0 0 � > \ƒ ( 0 0 9/ ) o R > Co E3 CD R CL § k 0 . Q / j _E \ \ r O y Z C ) \ CD C » o c ® D Q § § m / } n 3 - _ � / (0) G m ] § \ z . \ m N . f K \ \ 0 C § C) a . \ 1317 North Road Invoice #M10283 Niles, OH 44446 Man Needs...One Solutiope -n (800)392-7233 Y sales@penncare.net Bill To: Ship To: Order#: M10283 Carmel Fire Dept. Carmel Fire Dept. PO: Tom Small Attn: Tom Payne 2 Civic Square Internet Order#: 109369 2 Civic Square Carmel, IN 46032 Terms: Net 30 Carmel, IN 46032 Order Date: 9/18/2017 Invoice Date: 9/18/2017 Ship Via: UPS Ground Code Name Price Qty Unit Ext Price 01-4681T Tourniquet, SOF Tactical, Original 23.48 5 each 117.40 07-25815 Gauze, Sterile Kendall Kerlix Roll, 4.5"x 4.1 yards 2.10 25 each 52.50 09-0449A Collar,Ambu Perfit ACE Adjustable Adult 5.75 60 each 345.00 01-097210 Suction, Catheters 10FR 0.25 50 each 12.50 04-33640 Sensor, Masimo SET Disposable LNCS PDTX-3 20.00 12 each 240.00 Pediatric 12-36252 Patient Mover 80"x 40" 25.00 0 each 0.00 Tracking # 1Z4760184395597902 Subtotal $767.40 Shipping $0.00 Total $767.40 Payments/Credits Balance $767.40 Page 1 of Printed: 9/18/2017 at 3:05:12 PM n z -0 $« S m 3 m 2 \ 0 § § § § § # 7 2 0 > E 0 % ? \ k 0 % = 2 E § § t m z \ O \ § § k \ 0 / E o o q o k . / 3 D ® \ - - A t tt t C) 2 > / & � & � & � & & n O D _ o = o C o = o c o c E n T m ~ ~ ¥ # T. 2 R 2 . a _ 7 q e 2 0 0 / » # k ) / / m ( \ k k § § § % u $ g E - 2 r- 5,: e $ § \ a k k / k g ( g m ( m © o . ; -n o C x CL 3 f a _ k } CD # Z O 2 3 \ I \ [ a C CD . E 7 o ƒ 3 % \ R & C 0 7 0 k k . E _ , I ® CD$ « ± \ E CL < , -4 C \ § 3 o f f � | ; e e e e e = # 7 §� / $ q_ i»$ § / � \ G / \ $ CL f ° < ° & < m ; QQ E J \ {$ i D \ o k 2 § § j / 0 / G 7 o C C) CA o z 2 § a m o o p o o « o 0 o n 0) 0 N) % N) § N) g � 6 ) # m J \ 7 Cl. 2 E _ $ % Z 9 7 3 _ ] 2 %k k k c } _0< = e° E © 0 D §o } = a § A \ \ � D J $ M 0 } \ E � =r O E % ? Z CD § 0 { CD \ m /_ 7 k / X q B 2 M \ C 2 cx / m } a CD § KCR CCL > $ Pb 69f 0) t § D 0 e / 7 / E CD Z C> CD S S 0 \ 1317 North Road Invoice #M10055.01 Niles, OH 44446 Man Needs...OneSolui/on (800)392-7233 Y sales@penncare.net Bill To: Ship To: Order M M10055 Carmel Fire Dept. Carmel Fire Dept. PO: TSmall 2 Civic Square 2 Civic Square Internet Order#: 109304 Carmel, IN 46032 Carmel, IN 46032 Terms: Net 30 Order Date: 9/7/2017 Invoice Date: 9/15/2017 Ship Via: UPS Ground Code Name Price Qty Unit Ext Price 12-3597Y Backboard Strap, Disposable Vinyl Sticky Yellow 5.40 15 set 81.00 Tracking # 1Z4760184399832659 Subtotal $81.00 Shipping $0.00 Total $81.00 Payments/Credits Balance $81.00 Page 1 of Printed: 9/15/2017 at 1:20:39 PM 1317 North Road Invoice #M10250 �` AR Niles, OH 44446 Pe n Needs...OneSo/utlon (800)392-7233 Y sales@penncare.net Bill To: Ship To: Order#: M10250 Carmel Fire Dept. Carmel Fire Dept. PO: Tom Small 2 Civic Square 2 Civic Square . Internet Order#: 113192 Carmel, IN 46032 Carmel, IN 46032 Terms: Net 30 Order Date: 9/15/2017 Invoice Date: 9/15/2017 Ship Via: UPS Ground Code Name Price Qty Unit Ext Price 01-36641 CPAP, Flow-Safe II with Nebulizer, Tee, 02 Tubing 63.00 3 each 189.00 Large Adult Mask 08-0960S Gloves, MicroFlex MidKnight Nitrile Small 100/box 10.62 20 box/1 212.40 01-018124 Nasopharyngeal Airway Adult, 24FR 3.50 10 each 35.00 01-287740 ET Tube, Rusch Flexi-Set- Uncuffed with Stylet 3.95 0 each 0.00 4.Omm 02-1050121 Syringe, Prefilled Saline 10mL in 12mL 0.65 120 each 78.00 Tracking # 1Z4760184392481541 Subtotal $514.40 Shipping $0.00 Total $514.40 Payments/Credits Balance $514.40 Page 1 of Printed: 9/15/2017 at 3:06:33 PM 1317 North Road Invoice #M10253 Niles, OH 44446 (800)392-7233 Many Needs...One Solution sales@penncare.net Bill To: Ship To: Order M M10253 Carmel Fire Dept. Carmel Fire Dept. PO: Tom Small 2 Civic Square 2 Civic Square Internet Order#: 109357 Carmel, IN 46032 Carmel, IN 46032 Terms: Net 30 Order Date: 9/15/2017 Invoice Date: 9/15/2017 Ship Via: Ship w/another or Code Name Price Qty Unit Ext Price 01-01143 Nebulizer, Hand-Held, Hudson 1.10 50 each 55.00 03-03113 Electrodes, QUIK-COMBO Connectors Pedi Edge 34.95 10 pair 349.50 RTS 03-03111 Electrodes, QUIK-COMBO Connectors Edge 33.00 10 pair 330.00 System Tracking # 1Z4760184396960945 Subtotal $734.50 Shipping $0.00 Total $734.50 Payments/Credits Balance $734.50 Page 1 of Printed: 9/15/2017 at 3:52:15 PM 1317 North Road Invoice #M9736.02 r. aRs Niles, OH 44446 b (800)392-7233 PMM.,n,yyNe1erds...One Solution sales@penncare.net Bill To: Ship To: Order#: M9736 Carmel Fire Dept. Carmel Fire Dept. PO: TomPayne 2 Civic Square 2 Civic Square Internet Order M 109224 Carmel, IN 46032 Carmel, IN 46032 Terms: Net 30 Order Date: 8/25/2017 Invoice Date: 9/15/2017 Ship Via: UPS Ground Code Name Price Qty Unit Ext Price 01-11217 Tracheotomy Oxygenator Trach Tee, Disposable 67.50 1 case/ 67.50 Tracking # 1Z4760184396815790 Subtotal $67.50 Shipping $0.00 Total $67.50 Payments/Credits Balance $67.50 Page 1 of Printed: 9/15/2017 at 7:11:51 AM 1317 North Road Invoice #M10079 Niles, OH 44446 (800)392-7233 ManyNeeds...OneSolution sales@penncare.net Bill To: Ship To: Order#: M10079 Carmel Fire Dept. Carmel Fire Dept. PO: TomPayne 2 Civic Square 2 Civic Square Internet Order#: 109313 Carmel, IN 46032 Carmel, IN 46032 Terms: Net 30 Order Date: 9/8/2017 Invoice Date: 9/11/2017 Ship Via: UPS Ground Qty Unit Ext Price I —Code Name Price 01-08790 Suction Catheter, Yankauer Bulb Tip with 72" 2.78 40 each 111.20 Tubing 01-03961 Suction, Canister Guardian 1200cc 5.65 60 each 339.00 Tracking # 1Z4760184399922927 Subtotal $450.20 Shipping $0.00 Total $450.20 Payments/Credits Balance $450.20 Page 1 of Printed: 9/11/2017 at 9:21:30 AM \ M $ n o . § 9 6 $ 0 O 2 _ / / 9 % / � k [ t I m 2 m CL § ¢ z t q � k O (13% ° ® > OD $ e O E e * a) k # U) ] >k \ % J \ O� � / � / / § § E \ ; ƒ 7 T. --Iz 2 \ w K O / O |§ z . m 8 � J > J 6 2 r- - k $ § 2 K a 7 § } } / a g k § E ) m 3 - f 2 / ƒ \ / 3 ( E _ CD _ - CDI E � « \ CD & i $ ( a O K 2 m ° ER ° o } C k \ E KJ CL § - ° 2 k a CL C f C §f a | \ 7 0 > ® / R CD Eƒ \ ) \ \ k } > 7 \� _ ) / t � 7 § -nza4 0 03° k }\/ § k m J ° e # m f a � CD = F �E c k / | B/ f \f G \ » - E ) § o > §/ & 0 E =r Cl) W \ q 0 \ � M 0 \ E \ \ n 7 2 z E ]cn $ F m c ƒ # \ § / \ 0 ® § 2 p \ B \ § CL \ ;o } § # CD2.( \ 69D \ / � CD z 8 ¥ k 1317 North Road Invoice #M10283.01 Niles, OH 44446 FT,yyfteds sales...OneSo/ut/on 392-7233 sales@penncare.net Bill To: Ship To: Order#: M10283 Carmel Fire Dept. Carmel Fire Dept. PO: Tom Small Attn: Tom Payne 2 Civic Square Internet Order#: 109369 2 Civic Square Carmel, IN 46032 Terms: Net 30 Carmel, IN 46032 Order Date: 9/18/2017 Invoice Date: 9/19/2017 Ship Via: UPS Ground Code Name Price Qty Unit Ext Price 12-36252 Patient Mover 80"x 40" 25.00 20 each 500.00 Tracking # 1Z4760184390792281 Subtotal $500.00 Shipping $0.00 Total $500.00 Payments/Credits Balance $500.00 Page 1 of Printed: 9/19/2017 at 10:19:43 AM