334136 01/04/19 CITY OF CARMEL, INDIANA VENDOR: 368918
/ .,• ONE CIVIC SQUARE PENN CARE INC. CHECK AMOUNT: $**"*9,314.30*
CARMEL, INDIANA 46032 1317 NORTH ROAD CHECK NUMBER: 334136
NILES OH 44446 CHECK DATE: 01/04/19
ITpN Cp'
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
102 R4467099 102135 M22679 8,280.00 EQUIPMENT BOXES
102 4239011 M23598 86.30 SPECIAL DEPT SUPPLIES
102 4239011 M23758 515.00 SPECIAL DEPT SUPPLIES
102 4239011 M23785 433.00 SPECIAL DEPT SUPPLIES
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995)
ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
Vendor# 368918
PENN CARE INC. 1N SUM OF$ 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
$1,034.30
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
M23598 42-390.11 $86.30 1 hereby certify that the attached invoice(s),or 12/21/18 M23598 Misc.EMS Supplies $86.30
1120 102 Prior Year 1120 102
M23758 42-390.11 $515.00 bill(s)is(are)true and correct and that the 12/31/18 M23758 Misc.EMS Supplies $515.00
1120 1 102 1 Prior Year materials or services itemized thereon for 1120 102
I M23785 I 42-390.11 I $433.00 1/3/19 I M23785 I Misc.EMS Supplies $433.00
1120 102 which charge is made were ordered and 1120 102
received except
Thursday,January 3,2019
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 #M23785
Niles OH 44446
(800)392-7233
ManyNeeds...One Solution sales@penncare.net
Bill To: Ship To: Order#: M23785
Carmel Fire Dept. Carmel Fire Dept. PO: 01032019
Attn: Denise Snyder Attn: Andrew Young Internet Order#: 126514
2 Civic Square 2 Civic Square Terms: Net 30
Carmel, IN 46032 Carmel , IN 46032 Order Date: 1/2/2019
Invoice Date: 1/2/2019
Ship Via: FedEx
Qty Onit Ext Price
04-372550 Glucometer,Arkray Assure Prism, 11.50 12 box/50 138.00
Test Strips, 50/box
02-018910 Infuser, Infu-Stat Disposable 1000mL 11.80 25 each 295.00
Subtotal $433.00
Shipping $0.00
Total $433.00
Payments/Credits
00
Page 1 of Printed: 1/2/2019 at 11:14:13 AM
1317 North Road Invoice #M23598
nr��.t Niles, 44446
(800)39292-7233
Many Needs....One Solution sales@penncare.net
Bill To: Ship To: Order M M23598
Carmel Fire Dept. Carmel Fire Dept. PO: 12212018
Attn: Denise Snyder Attn:Andrew Young Internet Order M 126453
2 Civic Square 2 Civic Square Terms: Net 30
Carmel, IN 46032 Carmel , IN 46032 Order Date: 12/21/2018
Invoice Date: 12/21/2018
Ship Via: FedEx
Code Name Price Qty Unit Ext Price
07-0240L OB Kit, Sealed Sterile 6.10 5 each 30.50
02-05232 Fluid, Sterile Water Bottle 250mL 1.70 24 each 40.80
Tracking # iZ4760180393519762 Subtotal $71.30
Shipping $15.00
Total $86.30
Payments/Credits
Page 1 of Printed: 12/21/2018 at 2:02:04 PM
„y R Invoice #M23758
1317 North Road
F.
MAN1 Niles, OH 44446
392-7233
P11flanyvNeeds....0ne Solution saes
@penncare.net.net
r=
Bill To: Ship To: Order#: M23758
Carmel Fire Dept. Carmel Fire Dept. PO: 12312018
Attn: Denise Snyder Attn:Andrew Young Internet Order#: 126505
2 Civic Square 2 Civic Square Terms: Net 30
Carmel, IN 46032 Carmel , IN 46032 Order Date: 12/31/2018
Invoice Date: 12/31/2018
Ship Via: FedEx
Ptiicd .Qty Unit
02-35838 IV Tubing,Amsino Extension Set, 1.00 400 each 400.00
Needleless Only, 8”
02-050403 Syringe, Luer-Lok, with 22g x 1.5" 0.15 200 each 30.00
Needle, 3cc
02-003310 IV Tubing, Needleless, 83", 10 Drop 1.70 50 each 85.00
Tracking # 784733521440 Subtotal $515.00
Shipping $0.00
Total $515.00
Payments/Credits
ee
Page 1 of Printed: 12/31/2018 at 3:41:21 PM
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
Vendor# 368918 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
PENN CARE INC. IN SUM OF$ 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
$8,280.00
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
102135 M22679 44-670.99 $8,280.00 1 hereby certify that the attached invoice(s),or 1/3/19 M22679 EMS Boxes $8,280.00
1120 Encumbered 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
Thursday,January 3,,2019
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
1317 North Road Invoice #M22679,
�C Niles, OH 44446
(800)392-7233
MWan yNeeds...One Solution' sales@penncare.net
Bill To: Ship To: Order#: M22679
Carmel Fire Dept. Carmel Fire Dept. PO: 102135
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: 11/20/2018
Invoice Date: 1/3/2019
Ship Via: UPS Ground
Qty Unit JExt,Price'.
14-4974BL Pelican 1555 with TrekPak Black 276.00 30 each 8,280.00
Subtotal $8,280.00
Shipping $0.00
Total $8,280.00
Payments/Credits
Kplrance
$81,280.00,, '.
Page 1 of Printed: 1/3/2019 at 9:27:03 AM