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Home My WebLink About333450 12/14/18 y d_.��A,N CITY OF CARMEL, INDIANA VENDOR: 00352626 ONE CIVIC SQUARE BOUND TREE MEDICAL LLC CHECK AMOUNT: $*****1,027.58* ,� CARMEL, INDIANA 46032 23537 NETWORK PLACE CHECK NUMBER: 333450 9�,__ ,%+ CHICAGO IL 60673-1235 CHECK DATE: 12/14/18 grow�°' DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 102 4239011 83056672 969.00 SPECIAL DEPT SUPPLIES 102 4239011 83057955 58.58 SPECIAL DEPT SUPPLIES VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) Vendor# 00352626 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER BOUND TREE MEDICAL LLC IN SUM OF$ CITY OF CARMEL 23537 NETWORK PLACE 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. CHICAGO, IL 60673-1235 Payee $969.00 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 83056672 42-390.11 $969.00 1 hereby certify that the attached invoice(s),or 12/11/18 83056672 Misc.Supplies $969.00 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, December 11,2018 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 distribution ledger classification if claim paid motor vehicle highway fund. - Clerk-Treasurer Bound Tree --.- Invoice Invoice�.>� 83056672 Correspondence Address: ,;-BOUND TREE MEDICAL,LLC: Date 12/10/2018 5000 Tuttle Crossing Blvd 23537 Network Place Dublin,OH 43016 Chicago IL 60673-1235 Page 1 of 1 PHONE:(800)633-0523Account# _ ( 101076 FAX:(800)2575713 www.boundtree.com TIN# 31-1739487 Ship To: SHIP001 CARMEL FIRE DEPT CARMEL FIRE DEPT 2 CIVIC SQ 2 CIVIC SQUARE CARMEL,IN 46032-7543 RECEIVING CARMEL,IN 46032-7543 PO,Number Sales Or'derNumber Account Manager. Stripping Method „" Ship Date Payment Teems 12102018 100328341 T SPECTOR NO FRT 12/10/2018 NET 30 Itefn# Description, ?n, Ordered, Shipped,, B%O Unit,Pdoe�- UOM, Eiit3Price HE FOLLOWING ITEMS SHIPPED FROM: 12 1605 ZEAGER RD SUITE 101 ELIZABETHTOWN,PA 17022 BTM Distributor License No:48002301A 177268 SMART CAPNOLINE PLUS NON INTUBATED, 1 1 0 $969.00 BX $969.00 ORAL NASAL W/02 TUBING, ADULT/INTERMEDIATE 100EA/BX Tracking Numbers: 784310842227 Note:•Indicates taxable item Merchandise 969.00 Mise 0.00 Tax : 0.00 Correspondence and inquiries can be sent to: •Freight' 0.00 5000 Tuttle Crossing Blvd Dublin,OH 43016 Deposit 0.00 Total 969.00 VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995) Vendor# 00352626 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER BOUND TREE MEDICAL LLC IN SUM OF$ CITY OF CARMEL 23537 NETWORK PLACE 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. CHICAGO, IL 60673-1235 Payee $58.58 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 83057955 42-390.11 $58.58 1 hereby certify that the attached invoice(s),or 12/12/18 83057955 EMS Supplies $58.58 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 Wednesday, December 12,2018 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 5-11-10-1.6 120— Cost 20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer Invoice Bound Tre'e Invoice 1 83057955 Correspondence Address: ~BOUND TREE MEDICAL,LLC Date ` 12/11/2018 5000 Tuttle Crossing Blvd 23537 Network Place Dublin,OH 43016 Page "_ ( 1 of 1 Chicago,IL 60673=1235 PHONE:(800)533-0523 Account# �. 101076 FAX:(800)257-5713 www.boundtree.com TIN# 31-1739487 Ship To: SHIP001 CARMEL FIRE DEPT CARMEL FIRE DEPT 2 CIVIC SQ 2 CIVIC SQUARE CARMEL,IN 46032-7543 RECEIVING CARMEL,IN 46032-7543 P,O Number ., Sales Order Number Account Managers Shipping Method Ship.Date Payment Terms 12112018 100332401 T SPECTOR NO FRT 12/11/2018 NET 30 item,#, _ Description' .Ordered Shipped,, .BIO Unit"Price' VOM Ext;Price . HE FOLLOWING ITEMS SHIPPED FROM: 12 1605 ZEAGER RD SUITE 101 ELIZABETHTOWN,PA 17022 BTM Distributor License No:48002301A 291860 Particulate Respirator,N95,REG Size,Cup,Blue, 1 1 0 $29.29 BX $29.29 Nosefoam,Fluid Resistant,Disp,LF 20/bx 6bx/cs 291860S Particulate Respirator,N95,SM Size,Cup,Blue, 1 1 0 $29.29 BX $29.29 Nosefoam,Fluid Resistant,Disp,LF 20/bx 6bx/cs Tracking Numbers: 784349755864 Note: Indicates taxable item Merchandise 58.58 Misc 0.00 Tax 0.00 Correspondence and inquiries can be sent to: Freight 0.00 5000 Tuttle Crossing Blvd Dublin,OH 43016 Deposit 0.00 58.58 Total,' i