HomeMy WebLinkAbout331219 10/17/18 � '"p�� CITY OF CARMEL, INDIANA VENDOR: 368918
ONE CIVIC SQUARE PENN CARE INC. CHECK AMOUNT: $*******202.80*
\ ii` CARMEL, INDIANA 46032 1317 NORTH ROAD CHECK NUMBER: 331219
'�'drow.i�. NILES OH 44446 CHECK DATE: 10/17/18_
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
102 4239011 21595 202.80 SPECIAL DEPT SUPPLIES
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
Vendor# 368918 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
PENN CARE INC. IN SUM OF$ 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
$202.80
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
21595 42-390.11 $202.80 1 hereby certify that the attached invoice(s),or 10/12/18 21595 Misc.EMS Supplies $202.80
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
Friday,October 12,2018
V4mo '_Zt
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 ##M21595
- r Niles, OH 44446 MY
(800)392-7233
ManyNeeds...One Solution sales@penncare.net
Bill To: Ship To: Order#: M21595
Carmel Fire Dept. Carmel Fire Dept. PO: 10122018
Attn: Denise Snyder Attn:Andrew Young Internet Order#: 123923
2 Civic Square 2 Civic Square Terms: Net 30
Carmel, IN 46032 Carmel , IN 46032 Order Date: 10/12/2018
Invoice Date: 10/12/2018
Ship Via: FedEx
Code Name Price :Qty Unit Ext Price
04-358523 Lancets, Acti-Lance Plus 23g, 1.8mm 18.20 4 boxmo 72.80
02-04986 IV Tubing, Amsino Standard IV Set, 2.00 50 each 100.00
Needleless, 83", 60 Drop
02-050403 Syringe, Luer-Lok,with 22g x 1.5" 0.15 200 each 30.00
Needle,3cc
Tracking # 783221860967 Subtotal $202.80
Shipping $0.00
Total $202.80
Payments/Credits
Ballprice $202.80
Page 1 of Printed: 10/12/2018 at 1:38:18 PM