HomeMy WebLinkAbout319161 11/30/17 1y d.C!Igy�
CITY OF CARMEL, INDIANA VENDOR: 368918
I ONE CIVIC SQUARE PENN CARE INC. CHECK AMOUNT: $*****1,129.00*
4' CARMEL, INDIANA 46032 1317 NORTH ROAD CHECK NUMBER: 319161
NILES OH 44446 CHECK DATE: 11/30/17
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
102 4239011 M12193 1,129.00 SPECIAL DEPT SUPPLIES
VOUCHER NO. WARRANT NO. Prescribed by state Board of Accounts City Form No.201 (Rev.1995)
ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
Vendor# 368918
PENN CARE INC. IN SUM OF$ 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
$1,129.00
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
M12193 42-390.11 $1,129.00 1 hereby certify that the attached invoice(s),or 11/28/17 M12193 $1,129.00
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, November 28,2017
David Haboush
Fire Chief
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
_ 1317 North Road Invoice #M12193
uEaR Niles, OH 44446
41111"Eim `� �� (800)392-7233
Many Needs...One Solution sales@penncare.net
Bill To: Ship To: Order#: M12193
Carmel Fire Dept. Carmel Fire Dept. PO: TomPayne
Attn: Tom Payne 540 W 136 Street Internet Order#: 109803
2 Civic Square Carmel, IN 46032 Terms: Net 30
Carmel, IN 46032 Order Date: 11/27/2017
Invoice Date: 11/28/2017
Ship Via: UPS Ground
. . - Nam.4 Price. e -
02-13383 IV Start Kit, with Site-Loc, 8" 4.00 100 each 400.00
Extension, Pre-Filled 10cc Syringe
02-1050121 Syringe, Prefilled Saline 10mL in 12mL 0.65 60 each 39.00
03-326850 Electrodes,Adult/Pediatric Foam 12.00 40 bag/50 480.00
38mm 50/bag
02-02135 IV Catheter, Introcan Safety 20g x 2.10 100 each 210.00
1.25"
Tracking # 1Z4760184398092424 Subtotal $1,129.00
Shipping $0.00
Total $1,129.00
Payments/Credits
Balance $1,129.00
Page 1 of Printed: 11/28/2017 at 9:02:14 AM