HomeMy WebLinkAbout105416 PENN CARE INC
City of Carmel
EachEachEachEachEachEachEachSub Total
Department:Account:Fund:
30030030030074143702-53605211-4031BK05-4831BK07-58541108-5764L07-0910907-02764Combat TourniquetShearsSharpie MarkerRecloseable Plastic BagGloves, Nitrile Exam PF 3.5 Mil, Blue Large,
Box of 100Gauze Pads ABD 5 x 9Gauze - 4" x 4.1 yds.$19.25$22.00$2.70$0.90$0.90$0.19$2.70Page 1 of 1$5,775.00$6,979.70$199.80$270.00$270.00$308.00$99.90$57.00
112042-390.11101General Fund
INDIANA RETAIL TAX EXEMPT
Send Invoice To:
CERTIFICATE NO. 003120155 002 0PURCHASE ORDER NUMBER
Carmel Fire Department
105416
FEDERAL EXCISE TAX EXEMPT
35-6000972
2 Civic Square
THIS NUMBER MUST APPEAR ON INVOICES, A/P
ONE CIVIC SQUARE
VOUCHER, DELIVERY MEMO, PACKING SLIPS,
CARMEL, INDIANA 46032-2584
Carmel, IN 46032-
SHIPPING LABELS AND ANY CORRESPONDENCE
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL - 1997
PLEASE INVOICE IN DUPLICATE
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTIONDEPARTMENTACCOUNTPROJECTPROJECT
ACCOUNTAMOUNT
Stop the Bleed Kits - CCS
$6,979.70
PAYMENT
7/27/2021368918
* A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE A
SHIPPING INSTRUCTIONS
PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN
PENN CARE INC. Carmel Fire Department
*SHIP PREPAID.
AFFIDAVIT ATTACHED. I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
VENDORSHIP
1317 NORTH ROAD 10701 N. College Avenue, Ste A
*C.O.D. SHIPMENT CANNOT BE ACCEPTED.THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
TO
*PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABE
Carmel, IN 46032-
*THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 194
NILES, OH 44446 -
ORDERED BY
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS
FREIGHT
Denise SnyderJames Crider
TITLE
58229Accreditation/Budget AdministratorDirector of Administration
105416
CONTROL NO.
CONTROLLER
QUANTITYUNIT OF MEASUREDESCRIPTIONUNIT PRICEEXTENSION