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HomeMy WebLinkAbout231300 04/08/14 (9) CITY OF CARMEL, INDIANA VENDOR: 179340 ONE CIVIC SQUARE LAERDAL MEDICAL CORP CHECK AMOUNT: $*****5,000.00* CARMEL, INDIANA 46032 P 0 BOX 8500-53168 CHECK NUMBER: 231300 PHILADELPHIA PA 19178-3168 CHECK DATE: 04/08/14 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 102 4467099 1-lI9UA3 5,000.00 OTHER EQUIPMENT - 'Laerdal'" helping save lives Invoice Laerdal Medical Corporation Date: 03/11/14 167 Myers Corners Road Quote#: 1-119UA3 Wappingers Falls, NY 12590 Acct#: 00119576 Terms: Net 30 Days Ph: 800-431-1055 Shipped: FedEx Ground Fax: 800-227-1143 FOB: Ship Point Bill To Ship To Carmel Fire Department Carmel Fire Department 2 Civic Square 2 Civic Square Carmel, IN 46032 Carmel, IN 46032 Attn: Division Chief Tom Small Item Part# Description Unit Quantity Unit Price Amount 1 205-05050DEMo ALS Simulator Manikin Demo Unit Pt 1 EA 1 5000.00 $5,000.00 Part 1 Serial # 205MO5080026 Total Amount $5,000.00 Tax Shipping Total Invoice $5,000.00 Payment Balance Due $5,000.00 Message r mit to: Laerdal Medical Corporation Attn: Patti Axelby 167 Myers Corners Rd. Wappingers Falls, NY 12590 Prescribed by State Board of Accounts City Form No.201 (Rev.1995) ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL 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. Payee Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 1-119ua3 $5,000.00 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 Clerk-Treasurer VOUCHER NO. WARRANT NO. ALLOWED 20 Laerdal Medical Corporation IN SUM OF $ 167 Mef-&-Corners Rd Wappingers Falls, NY 12590 $5,000.00 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1120 I 1-119ua3 1102-670.99 I $5,000.00 1 hereby certify that the attached invoice(s), or 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 A 9 � .a 920 114 d. Fire Chief Title Cost distribution ledger classification if claim paid motor vehicle highway fund