HomeMy WebLinkAboutPennCare Inc./CFD/$24,500/Video Laryngoscopes ASA #2
PennCare, Inc.
Fire Department - 2024
Appropriation #1120 44-670.06 Fund; P.O. #112929
Contract Not To Exceed $24,500.00
ADDITIONAL SERVICES AMENDMENT TO
AGREEMENT FOR GOODS AND SERVICES
This ADDITIONAL SERVICES AMENDMENT TO AGREEMENT FOR GOODS AND SERVICES (“Additional
Services Amendment”) shall amend the terms of the Agreement for Purchase of Goods and Services entered into by
and between the City of Carmel and PennCare, Inc. (the “Vendor”) as City Contract dated October 2, 2019 (the
“Agreement”) by adding the additional services to be provided by Vendor consistent with the Scope of Work attached
hereto and incorporated herein as Exhibit “A”. The terms and conditions of the Agreement shall not otherwise be
affected by this Additional Services Amendment and shall remain in full force and effect.
IN WITNESS WHEREOF, the parties hereto have made and executed this Additional Services Amendment as follows:
CITY OF CARMEL, INDIANA PennCare, Inc.
By: By:
Zachary Q. Jackson Authorized Signature
Chief Financial Officer/Controller
Date:
Printed Name
Title
FID/TIN:
Date:
Jeannette Chicoine
Office Manager
34-1756819
November 25, 2024
12/3/2024
Bill To:
Carmel Fire Department Administration
Building
Attn: Denise Snyder
210 Veterans Way
Carmel, IN 46032
Ship To:
Carmel Fire Department
Attn: Ems Division
2 Civic Square
Carmel, IN 46032
(317) 571-2600
Penn Care, Inc.
1317 North Road
Niles, OH 44446
(800) 392-7233
sales@penncare.net
Order #124620
Ship Via:
Name Ext Price TaxPriceQtyCode
Order #: 124620
Terms: Net 30
Order Date: 11/18/2024
Expiration Date: 10/25/2024
24,500.00 √1,750.00 1401-707301 Video Laryngoscope, OneScope Pro, Auto Record
& Password
$24,500.00Subtotal
$24,500.00Balance
$0.00Payments/Credits
Shipping
$24,500.00Total
Tracking #
Printed: 11/18/2024 at 12:59:07 PMPage 1 of 1