184833 04/27/2010 CITY OF CARMEL, INDIANA VENDOR: 362944 Page 1 of 1
ONE CIVIC SQUARE LIFESAVERS, INC
QJ� CHECK AMOUNT: $285.42
CARMEL, INDIANA 46032 39 PLYMOUTH STREET
`o FAIRFIELD NJ 07004 CHECK NUMBER: 184833
CHECK DATE: 4/2712010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4239039 29334 285.42 GENERAL PROGRAM SUPPL
LIIFESAM INC Invoice
39 Plymouth Street Date Invoice
Fairfield NJ 07004 1 `7
3/30/2010 29334
Phone: (973)244-9111 Fax: (973)244-1666
Bill To Ship To
Carmel Clay Parks Recreation Carmel Clay Parks Recreation
Administrative Offices Attn: Linda Acosta
1411 E. 116th Street 1235 Central Park Dr E.
Carmel IN 46032 Carmel, IN 46032
P.O. Number Terms Rep Entered On Ship Via F.O.B. Project
23317 Net 30 MD 3/30/2010 UPS origin
Quantity Item Code Description Price Each Amount
Moore
2 216 -036 #791X Rescue Blanket Disposable 1/ unit 3.60 7.20
1 216 -002 Ice Pack Certi -Cool JR Bulk 25 /case 15.50 15.50
1 233 -361 Certicporyn Triple Antibiotic Ointment Igm -50 /box 7.70 7.70
4 231 -208 Gauze Pads 4x4 IObx 2.00 8.00
2 MISCFA Oral Thermometer (non mercury /non glass) 14.99 29.98
10 CT4056 Triangular Bandage (w /pins) 40X4Ox56 0.65 6.50
I go-loot Heartsaver Pediatric First Aid 13.95 13.95
Subtotal 88.83
K Miller
1 211-032 #629 Trauma Pad Compress 8" x 10" 1 /unit 1.80 1.80
4 213-011 #663 Certi -Sporyn Antibiotic Cream Igm. 10 /unit 1.80 7.20
1 216 -036 9791X Rescue Blanket Disposable If unit 3.60 3.60
1 237 -016 Scissors Bandage 5 1/2" Stainless Steel 4.80 4.80
1 D3103 Gauze stretch 3" non sterile 12 /bag 4.35 4.35
2 216 -025 #794 Hydrocortisone Cream 1 gm. 6 /unit 1.78 3.56
-1 -CT4056__ -Triang d a,- Bandage(.v /pins).40XAOX -56 0.,65. 0.6c-
1 80 -1034 Family Friends First Aid for Children (5) 7.50 7.50
1 MISCFA Oral Thermometer (non mercury /non glass( 14.99 14.99
1 MISCFA box of disposable thermometer covers 60 /box 5.99 5.99
Subtotal 54.44
A Livingston
2 220 -103 Adhesive Vinyl Bandages I "x 3 100 /box 4.10 8.20
2 220 -100 Adhesive Vinyl Bandages -3/4 "x 3" -100 /box 3.90 7.80
2 220 -014 Adhesive Vinyl Bandages Jr. XL -100 /box 330 6.60
4 220 -020 Adhesive Vinyl Bandages X Large 2 "x3" -25 /box 4.60 18.40
2 220 -128 Fingertip Bandage Small Woven 50 /bx 6.00 12.00
2 220 -213 Woven Fingertip Bandage Medium -50 /box 5.80 11.60
Thank you for your business. Inquiries (973) 244-9111
Total
Page 1
a
IFES a� IN C. Invoice
9 Plymouth Street Date Invoice
Fairfield NJ 07004
3/30/2010 29334
Phone: (973)244-9111 Fax: (973)244-1666
Bill To Ship To
Carmel Clay Parks Recreation Carmel Clay Parks Recreation
Administrative Offices Attn: Linda Acosta
1411 E. i 16th Street 1235 Central Park Dr E.
Carmel IN 46032 Carmel, IN 46032
P.O. Number Terms Rep Entered On Ship Via F.O.B. Project
23317 Net 30 MD 3/30/2010 UPS origin
Quantity Item Code Description Price Each Amount
2 220 -220 Knuckle Woven Bandage 50 /box 5.80 11.60
2 221 -039 Antiseptic Wipes 50 /box 3.80 7.60
2 233 -361 Certicporyn Triple Antibiotic Ointment Igm -50 /box 7.70 15.40
2 D3103 Gauze stretch 3" non sterile 12 /bag 4.35 8.70
2 231 -211 Gauze Pads 3" x 3" 25 /box 3.10 6.20
5 231 -208 Gauze Pads 4x4 1 Obx 2.00 10.00
20 CT4056 Triangular Bandage (w /pins) 40X40x56 0.65 13.00
10 216 -015 #783 Forceps Scissors I each /unit 1.54 15.40
12 216 -025 #794 Hydrocortisone Cream 1 gm. 6 /unit 1.78 21.36
Subtotal 173.86
Subtotal 317.13
DISC Special Discount 10.00% -31.71
I ZY527Y 10348571693
Purchase �ff;r Al D S�PPu S
Dweriptiott a�J`bl'7 P or F (0 5
P.O.# CjD�JC) i V
Budget (1�
Una Deser
Purchaser Date____
Date. Z
ApRro
Thank you for your business. Inquiries (973) 244 -91 1
Total X285.42
Page 2
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of 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.
Payee
Purchase Order No.
362944 LifeSavers, Inc. Terms
39 Plymouth Street
Fairfield, NJ 07004
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
3/30/10 29334 First aid supplies 23317 64.57
3130110 29334 First aid supplies 23317 36.87
3130/10 29334 First aid supplies 23317 183.98
Total 285.42
1 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_
Clerk- Treasurer
Voucher No. Warrant No.
362.944 LifeSavers, Inc. Allowed 20
39 Plymouth Street
Fairfield, NJ 07004
In Sum of
285.42
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO, ACCT XTITLE AMOUNT Board Members
Dept
1081 -1 29334 yo M0- 64.57 1 hereby certify that the attached invoice(s), or
1081 -5 29334 j a51'b�9 36.87 bill(s) is (are) true and correct and that the
1081 -2 29334 C�69 183.98 materials or services itemized thereon for
which charge is made were ordered and
received except
22 -Apr 2010
Signature
285.42 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund