City of San Diego PO No. 4500091910 PURCHASE ORDER
Date: 08/10/2017 Page 1 of 6
Ship To: Bill To: Billing Contact: SAN DIEGO FIRE DEPT SDFD URBAN SEARCH/RESCUE Carmen Camou SPECIAL OPERATIONS SPECIAL OPERATIONS NTC-4347 Spruance RD BLDG 557 SUITE 400 Telephone: SAN DIEGO CA 92101-4912 1010 SECOND AVE SAN DIEGO CA 92101 E-Mail:[email protected] Terms: Vendor: Boundtree Medical LLC within 30 days Due net 23537 Network Place Delivery Terms: Chicago IL 60673-1235 FOB Destination
Buyer: Ray Falcon Telephone: 619-236-6037 Vendor ID: 10005767 Telephone:330-523-5036 E-Mail: [email protected] E-Mail: [email protected]
Line # Item ID/Description Del.Date Quantity/UM Unit Price Extended Price
1 Item 18428 Betadine 8 oz 08/31/2018 3.19 EA USD 24.00 USD 76.56 Medical supplies for US&R CA-TF8 medical cache used for deployments see attached quote with itemized list.
Contact: Carmen Camou 619 533-4331
*Federal Funded Program*
Non-Deductible Tax USD 5.93
2 Item 8153-03 Betadine (PVP) Swabstick 08/31/2017 43.29 EA USD 1.00 USD 43.29 Non-Deductible Tax USD 3.36
3 Item 0017-04 Gold Bond Foot Powder 4 oz 08/01/2017 5.59 EA USD 12.00 USD 67.08 Non-Deductible Tax USD 5.20
4 Item 1893-01 C2 MOrphine Sulfate 08/01/2017 36.99 EA USD 5.00 USD 184.95 Non-Deductible Tax USD 14.33
5 Item 0203-01 C2 Oxycodone 08/01/2017 77.99 EA USD 2.00 USD 155.98 Non-Deductible Tax USD 12.09
6 Item 4699-24 Propofol 10mg/ml 08/01/2017 45.79 EA USD 10.00 USD 457.90 Non-Deductible Tax USD 35.48
7 Item BR0285-20 C4 Diazepam 5mg 08/01/2017 14.29 EA USD 1.00 USD 14.29 Non-Deductible Tax USD 1.11
8 Item 371124 C2 Fentanyl 0.05mg 08/01/2017 26.99 EA USD 3.00 USD 80.97 Non-Deductible Tax USD 6.27
9 Notes: The Terms and Conditions of this Purchase Order are available at http://sandiego.gov/purchasing/ SEE LAST PAGE IMPORTANT! FOR TOTAL
To ensure prompt payments, PO # must appear on all shipments and invoices; all invoices must be directed to Billing Contact person at Bill-To address listed above Rev 04 - 16 City of San Diego PO No. 4500091910 PURCHASE ORDER Date: 08/10/2017 Page 2 of 6
Line # Item ID/Description Del.Date Quantity/UM Unit Price Extended Price
Item 0181-20 C3 Ketamine 10mg 08/01/2017 350.99 EA USD 2.00 USD 701.98 Non-Deductible Tax USD 54.40
10 Item 2305-05 C4 Midazolam 5mg 08/01/2017 18.99 EA USD 2.00 USD 37.98 Non-Deductible Tax USD 2.94
11 Item 6044-25 C4 Lorazepam 2mg 08/01/2017 90.99 EA USD 1.00 USD 90.99 Non-Deductible Tax USD 7.05
12 Item G0902 IV Solution, Sodium Chloride 08/01/2017 3.93 EA USD 28.00 USD 110.04 Non-Deductible Tax USD 8.53
13 Item 358437 IV Solution, Sodium Chloride 08/01/2017 2.99 EA USD 15.00 USD 44.85 Non-Deductible Tax USD 3.47
14 Item 0377-08 C4 Tramadol 50mg Tablet 100 08/01/2017 7.29 EA USD 1.00 USD 7.29 Non-Deductible Tax USD 0.57
15 Item 4759-01 ONDANSETRON 2MG/ML, 20ML VI 08/01/2017 38.49 EA USD 1.00 USD 38.49 Non-Deductible Tax USD 2.98
16 Item 660242 Suture with Needle 08/01/2017 65.99 EA USD 1.00 USD 65.99 Non-Deductible Tax USD 5.11
17 Item 38022 Curaplex Endotracheal Tube wi 08/01/2017 2.37 EA USD 2.00 USD 4.74 Non-Deductible Tax USD 0.36
18 Item 70-580011EA Heat moisture exchanger 08/01/2017 4.64 EA USD 10.00 USD 46.40 Non-Deductible Tax USD 3.59
19 Item 2144-KV311 King Vision Kit 08/01/2017 1,369.99 EA USD 2.00 USD 2,739.98 Non-Deductible Tax USD 212.35
20 Item 531799 PEEP VALVE DISPOSABLE 08/01/2017 4.02 EA USD 12.00 USD 48.24 Non-Deductible Tax USD 3.73
21 LMA Supreme, Size 4, Adult 50-70 kg, w/I 08/01/2017 39.99 EA USD 6.00 USD 239.94 Non-Deductible Tax USD 18.60
22 Curaplex GSA Thoracentesis Kit, incl 14 08/01/2017 106.99 EA USD 9.00 USD 962.91 Non-Deductible Tax USD 74.62
Notes: The Terms and Conditions of this Purchase Order are available at http://sandiego.gov/purchasing/ SEE LAST PAGE IMPORTANT! FOR TOTAL To ensure prompt payments, PO # must appear on all shipments and invoices; all invoices must be directed to Billing Contact person at Bill-To address listed above
Rev 04 - 16 City of San Diego PO No. 4500091910 PURCHASE ORDER Date: 08/10/2017 Page 3 of 6
Line # Item ID/Description Del.Date Quantity/UM Unit Price Extended Price
23 Curaplex Cricothyrotomy Kit, Adult, w/Gl 08/01/2017 19.49 EA USD 8.00 USD 155.92 Non-Deductible Tax USD 12.09
24 Curaplex Chest Decompression Set 08/01/2017 22.99 EA USD 4.00 USD 91.96 Non-Deductible Tax USD 7.13
25 needle, Exel, hypodermic, regular bevel, 08/01/2017 0.05 EA USD 15.00 USD 0.75 Non-Deductible Tax USD 0.06
26 HYPODERMIC NEEDLE STERILE 22 GAUGE X 1 1 08/01/2017 12.99 EA USD 1.00 USD 12.99 Non-Deductible Tax USD 1.00
27 HYPODERMIC NEEDLE STERILE 18 GAUGE X 1 I 08/01/2017 12.99 EA USD 1.00 USD 12.99 Non-Deductible Tax USD 1.00
28 NEEDLE BD 27G X 1/2 in 100/bx 10bx/cs 08/01/2017 7.39 EA USD 1.00 USD 7.39 Non-Deductible Tax USD 0.57
29 Pressure Infuser, INFU-STAT Bag, 1000ml 08/01/2017 15.79 EA USD 16.00 USD 252.64 Non-Deductible Tax USD 19.58
30 Blood Tube, Monoject, Red, 7ml, No Addit 08/01/2017 0.31 EA USD 100.00 USD 31.00 Non-Deductible Tax USD 2.41
31 Urine meter foley tray, Lubri-Sil, 10 Fr 08/01/2017 98.99 EA USD 4.00 USD 395.96 Non-Deductible Tax USD 30.69
32 FOLEY CATHETER TRAY, 16 FR, 5CC, INCL TR 08/01/2017 14.69 EA USD 4.00 USD 58.76 Non-Deductible Tax USD 4.55
33 MULTISTIX 10 SG URINE REAGENT STRIPS 100 08/01/2017 78.99 EA USD 2.00 USD 157.98 Non-Deductible Tax USD 12.24
34 ARGYLE STRAIGHT THORACIC CATHETER, CHEST 08/01/2017 79.99 EA USD 2.00 USD 159.98 Non-Deductible Tax USD 12.40
35 QUICK CHEST TUBE TRAY 36FR 41CM 08/01/2017 276.99 EA USD 2.00 USD 553.98 Non-Deductible Tax USD 42.93
36 ARGYLE STRAIGHT THORACIC CATHETER, CHEST 08/01/2017 79.99 EA USD 1.00 USD 79.99 Non-Deductible Tax USD 6.20
Notes: The Terms and Conditions of this Purchase Order are available at http://sandiego.gov/purchasing/ SEE LAST PAGE IMPORTANT! FOR TOTAL To ensure prompt payments, PO # must appear on all shipments and invoices; all invoices must be directed to Billing Contact person at Bill-To address listed above
Rev 04 - 16 City of San Diego PO No. 4500091910 PURCHASE ORDER Date: 08/10/2017 Page 4 of 6
Line # Item ID/Description Del.Date Quantity/UM Unit Price Extended Price
37 QUICK CHEST TUBE TRAY 32FR 41CM 08/01/2017 239.99 EA USD 2.00 USD 479.98 Non-Deductible Tax USD 37.20
38 Lancets, Assure Lance, 25 ga x 2 mm 100/ 08/01/2017 15.79 EA USD 1.00 USD 15.79 Non-Deductible Tax USD 1.23
39 chest tube kit, sterile, with tray 20ea/ 08/01/2017 21.29 EA USD 4.00 USD 85.16 Non-Deductible Tax USD 6.60
40 DUCT TAPE WHITE, 2 INCH X 60 YDS 24/CS 08/01/2017 7.19 EA USD 6.00 USD 43.14 Non-Deductible Tax USD 3.35
41 Washcloth, Disposable, Wet Wipes, Premoi 08/01/2017 29.49 EA USD 1.00 USD 29.49 Non-Deductible Tax USD 2.29
42 Gloves, ApexPro SC 100, SM, Nitrile, Pow 08/01/2017 13.19 EA USD 3.00 USD 39.57 Non-Deductible Tax USD 3.06
43 Gloves, ApexPro SC 100, MED, Nitrile, Po 08/01/2017 13.19 EA USD 6.00 USD 79.14 Non-Deductible Tax USD 6.14
44 Gloves, ApexPro SC 100, LG, Nitrile, Pow 08/01/2017 13.19 EA USD 10.00 USD 131.90 Non-Deductible Tax USD 10.22
45 Gloves, ApexPro SC 100, XL, Nitrile, Pow 08/01/2017 13.19 EA USD 10.00 USD 131.90 Non-Deductible Tax USD 10.22
46 Gloves, ApexPro SC 100, 2XL, Nitrile, Po 08/01/2017 13.19 EA USD 3.00 USD 39.57 Non-Deductible Tax USD 3.06
47 HAND CLEANSER NO RINSE 4 OZ 36/CS ISAGEL 08/01/2017 3.05 EA USD 84.00 USD 256.20 Non-Deductible Tax USD 19.85
48 NEEDLE, STRAIGHT, #0 SILK SUTURE, 30 IN 08/01/2017 331.99 EA USD 1.00 USD 331.99 Non-Deductible Tax USD 25.73
49 SUTURE ETHICON NYLON MONO 3-0 FS-1 BLACK 08/01/2017 299.99 EA USD 1.00 USD 299.99 Non-Deductible Tax USD 23.25
50 SUTURE VICRYL 4-0 W/ RB-1 NEEDLE VIOLET 08/01/2017 321.99 EA USD 1.00 USD 321.99 Non-Deductible Tax USD 24.95
Notes: The Terms and Conditions of this Purchase Order are available at http://sandiego.gov/purchasing/ SEE LAST PAGE IMPORTANT! FOR TOTAL To ensure prompt payments, PO # must appear on all shipments and invoices; all invoices must be directed to Billing Contact person at Bill-To address listed above
Rev 04 - 16 City of San Diego PO No. 4500091910 PURCHASE ORDER Date: 08/10/2017 Page 5 of 6
Line # Item ID/Description Del.Date Quantity/UM Unit Price Extended Price
51 SUTURE ETHICON NYLON MONO 5-0 FS-2 BLACK 08/01/2017 102.99 EA USD 1.00 USD 102.99 Non-Deductible Tax USD 7.98
52 Assorted Bandages, Johnson and Johnson, 08/01/2017 6.59 EA USD 3.00 USD 19.77 Non-Deductible Tax USD 1.54
53 BANDAGE ADHESIVE 2 IN X 3 IN FLEXIBLE PA 08/01/2017 11.69 EA USD 3.00 USD 35.07 Non-Deductible Tax USD 2.72
54 SUTURE REMOVAL KIT 50EA/CS 08/01/2017 1.37 EA USD 10.00 USD 13.70 Non-Deductible Tax USD 1.06
55 Minor Procedure Tray 3 in Fenestrated Dr 08/01/2017 262.99 EA USD 1.00 USD 262.99 Non-Deductible Tax USD 20.38
56 PACKING STRIPS IODOFORM 1/4 IN X 5 YDS 1 08/01/2017 56.99 EA USD 1.00 USD 56.99 Non-Deductible Tax USD 4.41
57 HYDROGEN PEROXIDE 3% 16 OZ 12EA/BX 08/01/2017 1.84 EA USD 10.00 USD 18.40 Non-Deductible Tax USD 1.42
58 Skin stapler, Reflex One, 35 wide, with 08/01/2017 85.99 EA USD 1.00 USD 85.99 Non-Deductible Tax USD 6.66
59 Skin Closure Strips, Steri-Strip, 1/4 in 08/01/2017 1.4 EA USD 10.00 USD 14.00 Non-Deductible Tax USD 1.09
60 Skin Closure Strips, Steri-Strip, 1/8 in 08/01/2017 1.46 EA USD 1.00 USD 1.46 Non-Deductible Tax USD 0.12
61 BENZOIN TINCTURE 2 OZ 08/01/2017 6.99 EA USD 4.00 USD 27.96 Non-Deductible Tax USD 2.17
62 MOLESKIN 2 IN X 4 IN STRIPS, 4 IN = 1 EA 08/01/2017 0.27 EA USD 16.00 USD 4.32 Non-Deductible Tax USD 0.33
63 DRESSING 2ND SKIN 3X6 1/2 08/01/2017 13.29 EA USD 2.00 USD 26.58 Non-Deductible Tax USD 2.05
64 Disinfectant Solution, Cidex Activated D 08/01/2017 47.79 EA USD 2.00 USD 95.58 Non-Deductible Tax USD 7.40
Notes: The Terms and Conditions of this Purchase Order are available at http://sandiego.gov/purchasing/ SEE LAST PAGE IMPORTANT! FOR TOTAL To ensure prompt payments, PO # must appear on all shipments and invoices; all invoices must be directed to Billing Contact person at Bill-To address listed above
Rev 04 - 16 City of San Diego PO No. 4500091910 PURCHASE ORDER Date: 08/10/2017 Page 6 of 6
Line # Item ID/Description Del.Date Quantity/UM Unit Price Extended Price
65 Bag, reclosable, 8 in. x 10 in., 2 mil c 08/01/2017 0.04 EA USD 1,000.00 USD 40.00 Non-Deductible Tax USD 3.10
66 Medikoff Throat Lozenge, Cherry, 75/bx 2 08/01/2017 6.19 EA USD 6.00 USD 37.14 Non-Deductible Tax USD 2.88
67 Fluorescein Sodium 1mg Strips 100/bx 08/01/2017 17.79 EA USD 1.00 USD 17.79 Non-Deductible Tax USD 1.38
68 Eye drop, Tetrasine, 1/2 oz, compares to 08/01/2017 2.88 EA USD 20.00 USD 57.60 Non-Deductible Tax USD 4.47
69 C4 Diazepam 10mg/2ml Auto-injector 15ea/ 08/01/2017 59.99 EA USD 90.00 USD 5,399.10 Non-Deductible Tax USD 418.44
70 CIPROFLOXACIN 500MG 100 UD 08/01/2017 45.79 EA USD 16.00 USD 732.64 Non-Deductible Tax USD 56.78
71 DOXYCYCLINE 100MG 500/BT 08/01/2017 1,449.99 EA USD 4.00 USD 5,799.96 Non-Deductible Tax USD 449.50
72 IOSAT POTASSIUM IODIDE 130MG TABS 14 UD/ 08/01/2017 19.79 EA USD 25.00 USD 494.75 Non-Deductible Tax USD 38.34
73 Cyanokit 5 gm Hydroxocobalamin Kit, Cont 08/01/2017 1,159.99 EA USD 4.00 USD 4,639.96 Non-Deductible Tax USD 359.60
Notes: The Terms and Conditions of this Purchase Order are available at http://sandiego.gov/purchasing/ Line Item Total $ 28,463.68 IMPORTANT! Tax $ 2,205.89
To ensure prompt payments, PO # must appear on all shipments and invoices; all invoices must be directed to Billing Contact person at Bill-To address listed above PO Total $ 30,669.57
Rev 04 - 16