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Home My WebLink About325557 05/23/18 CITY OF CARMEL, INDIANA VENDOR: 368918 I ONE CIVIC SQUARE PENN CARE INC. CHECK AMOUNT: $••"'"1,274.75• CARMEL, INDIANA 46032 1317 NORTH ROAD CHECK NUMBER: 325557 9gj�TON. � NILES OH 44446 CHECK DATE: 05/23/18 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 102 4239011 iM12641 180.00 SPECIAL DEPT SUPPLIES 102 4239011 M16741 111.50 SPECIAL DEPT SUPPLIES 102 4239011 M16770'.01 19.25 SPECIAL DEPT SUPPLIES 102 4239011 M16815 392.20 SPECIAL DEPT SUPPLIES 102 4239011 M16998 345.00 SPECIAL DEPT SUPPLIES 102 4239011 M17080 226.80 SPECIAL DEPT SUPPLIES VOUCHER NO. WARRANT NO. Prescribed by state Board of Accounts City Form No.201 (Rev.1995) Vendor# 368918 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER PENN CARE INC. IN SUM OF$ 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 $1,274.75 ON ACCOUNT OF APPROPRIATION FOR Purchase Order# 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 M17080 42-390.11 $226.80 1 hereby certify that the attached invoice(s),or 5/21/18 M17080 $226.80 1120 102 1120 102 M16815 42-390.11 $392.20 bill(s)is(are)true and correct and that the 5/21/18 M16815 $392.20 1120 102 materials or services itemized thereon for 1120 102 M16741 42-390.11 $111.50 5/21/18 M16741 $111.50 1120 102 which charge is made were ordered and 1120 102 M16998 42-390.11 $345.00 received except 5/21/18 M16998 $345.00 1120 102 1120 102 M16670.01 42-390.11 $19.25 5/21/18 M16670.01 $19.25 1120 102 1120 102 M12641 42-390.11 $180.00 5/21/18 M12641 $180.00 1120 102 1120 102 Monday, May 21,2018 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 - 1317 North Road Invoice #M17080 Niles, OH 44446 (800)392-7233 Many Needs....OneSolution sales@penncare.net Bill To: Ship To: Order#: M17080 Carmel Fire Dept. Carmel Fire Dept. PO: 5182018 Attn: Denise Snyder Attn:Andrew Young Internet Order#: 113882 2 Civic Square 2 Civic Square Terms: Net 30 Carmel, IN 46032 Carmel , IN 46032 Order Date: 5/18/2018 Invoice Date: 5/21/2018 Ship Via: Ground Code Name Prii - Qty 'Unit ,Ext Price 02-35838 IV Tubing,Amsino Extension Set, 8" 1.10 100 each 110.00 Needleless Only 07-36355 Gauze, QuikClot 3"x 48" Rolled 20.00 4 each 80.00 07-34471 Gauze, Emergency High Strength 9.20 4 each 36.80 Pressure Bandages 4" Tracking # 1Z4760180398986589 Subtotal $226.80 Shipping $0.00 Total $226.80 Payments/Credits 13P llonce, $226.00 Page 1 of Printed: 5/21/2018 at 7:13:34 AM 4. �- - 1317 North Road Invoice #M16741 PMrC ._ Niles, OH 44446 11 (800)392-7233 Many Needs....One Solution . sales@penncare.net Bill To: Ship To: Order#: M16741 Carmel Fire Dept. Carmel Fire Dept. PO: Attn: Denise Snyder Attn:Andrew Young Internet Order M 2 Civic Square 2 Civic Square Terms: Net 30 Carmel, IN 46032 Carmel , IN 46032 Order Date: 5/8/2018 Invoice Date: 5/8/2018 Ship Via: Ground �ode Nam- - • 01-361904 i-Gel Supraglottic Airway Size 4.0 for 22.30 5 each 111.50 Medium Adults(110-200lbs.) Tracking # 1Z4760180394590585 Subtotal $111.50 Shipping $0.00 Total $111.50 Payments/Credits Page 1 of Printed: 6/8/2018 at 12:46:42 PM 5 Y 1317 North Road Invoice #M16998 ��` Niles, OH 44446 (800)392-7233 Many Needs...One Solution sales@penncare.net Bill To: Ship To: Order#:,M16998 Carmel Fire Dept. Carmel Fire Dept. PO: 051618 Attn: Denise Snyder Attn:Andrew Young Internet Order#:- 2 Civic Square 2 Civic Square Terms: Net 30 Carmel, IN 46032 Carmel , IN 46032 Order Date: 5/16/2018 Invoice Date: 5/17/2018 Ship Via: Ground a e - 12-36252 Patient Mover 80"x 40" 17.25 20 each 345.00 Tracking # 781006486339 Subtotal $345.00 Shipping $0.00 Total $345.00 Payments/Credits - BI Page 1 of Printed: 5/1712018 at 8:30:12 AM 1317 North Road Invoice #M16670.01 Niles, OH44.44.6 (800)39292-7233 Many Needs...One Solution sales@penncare.net Bill To: Ship To: Order#: M16670 Carmel Fire Dept. Carmel Fire Dept. PO: 5072018 Attn: Denise Snyder Attn:Andrew Young Internet Order#: 113786 2 Civic Square 2 Civic Square Terms: Net 30 Carmel, IN 46032 Carmel , IN 46032 Order Date: 5/7/2018 Invoice Date: 5/17/2018 Ship Via: Ground Code Name Price;. Qty Unit Ext Price 01-018312 Stylet, Flexi-Slip, Teleflex 12FR 2.75 7 each 19.25 Subtotal $19.25 Shipping $0.00 Total $19.25 Payments/Credits Balance Page 1 of Printed: 5/17/2018 at 12:09:10 PM 1317 North Road Invoice #M12641 Niles, OH 44446 (800)392-7233 ManyNeeds...One Solution sales@penncare.net Bill To: Ship To: Order#: M12641 Carmel Fire Dept. Carmel Fire Dept. PO: Attn: Denise Snyder Attn: Denise Snyder Internet Order M 2 Civic Square 2 Civic Square Terms: Net 30 Carmel, IN 46032 Carmel, IN 46032 Order Date: 12/13/2017 Invoice Date: 12/26/2017 Ship Via: UPS Ground Code Name Price Qty; Unit Ext Price Carmel Fire Dept. 11-477535 SSCORE VX-2 Replacment Battery 60.00 3 each 180.00 Tracking # 1Z4760184399892648 Subtotal $180.00 Upon being audited, it was discovered the original invoice was Shipping $11.51 printed with just the shipping amount. This invoice is for the actual product. Total $191.51 Payments/Credits $11.51 $180.00 Page 1 of 1 Printed: 5/18/2018 at 1:52:44 PM 1317 North Road Invoice #M16815 - r Niles, OH 44446 (800)392-7233 Many Needs...One Solution sales@penncare.net Bill To: Ship To: Order#: M16815 Carmel Fire Dept. Carmel Fire Dept. PO: 05102018 Attn: Denise Snyder Attn:Andrew Young Internet Order M 2 Civic Square 2 Civic Square Terms: Net 30 Carmel, IN 46032 Carmel , IN 46032 Order Date: 5/10/2018 Invoice Date: 5/10/2018 Ship Via: Ground 03-11937 Electrodes, EDGE System with QUIK- 37.45 10 pair 374.50 COMBO Connector& REDI-PAK 03-0369P Electrodes, Medi-Trace Quick Combo 17.70 1 pair 17.70 Electrode, Heart Sync Quick Combo Tracking # 780912002887 Subtotal $392.20 Shipping $0.00 Total $392.20 Payments/Credits Page 1 of Printed: 5/10/2018 at 2:16:16 PITA