Loading...
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